Provider Demographics
NPI:1952675928
Name:BAIRD, REBECCA JANE (MA, NCC, LPCA)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:JANE
Last Name:BAIRD
Suffix:
Gender:F
Credentials:MA, NCC, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 WESTWOOD LN
Mailing Address - Street 2:SUITE 6, ROOM 5
Mailing Address - City:WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28697-2626
Mailing Address - Country:US
Mailing Address - Phone:828-262-8661
Mailing Address - Fax:
Practice Address - Street 1:1301 WESTWOOD LN
Practice Address - Street 2:STE 6, RM 5
Practice Address - City:WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28697-2626
Practice Address - Country:US
Practice Address - Phone:828-262-8661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-08
Last Update Date:2015-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA9006101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor