Provider Demographics
NPI:1972275790
Name:BAYLOR, LINDA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:
Last Name:BAYLOR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9168
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06532-0168
Mailing Address - Country:US
Mailing Address - Phone:203-928-0098
Mailing Address - Fax:
Practice Address - Street 1:458 GRAND AVE STE 109
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06513-3873
Practice Address - Country:US
Practice Address - Phone:203-928-0098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3118101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional