Provider Demographics
NPI:1821663089
Name:BAYNES, DEANISHA (LMSW)
Entity Type:Individual
Prefix:
First Name:DEANISHA
Middle Name:
Last Name:BAYNES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8500 ANNAPOLIS RD STE A8
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-3020
Mailing Address - Country:US
Mailing Address - Phone:855-218-8200
Mailing Address - Fax:
Practice Address - Street 1:8500 ANNAPOLIS RD STE A8
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-3020
Practice Address - Country:US
Practice Address - Phone:855-218-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27086104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0Other0