Provider Demographics
NPI:1881229771
Name:CHRISTINE BAYLESS LLC
Entity Type:Organization
Organization Name:CHRISTINE BAYLESS LLC
Other - Org Name:THREE STONES WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOTHERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAYLESS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:720-938-6071
Mailing Address - Street 1:3800 PIKE RD APT 9204
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-6926
Mailing Address - Country:US
Mailing Address - Phone:720-938-6071
Mailing Address - Fax:
Practice Address - Street 1:500 9TH AVE
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-4598
Practice Address - Country:US
Practice Address - Phone:720-938-6071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-11
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)