Provider Demographics
NPI:1740476498
Name:BAYLEY, ANDREA LOFTUS (LCSW)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:LOFTUS
Last Name:BAYLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:MARIE
Other - Last Name:LOFTUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23 COURT PARK
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119-2002
Mailing Address - Country:US
Mailing Address - Phone:860-385-1494
Mailing Address - Fax:
Practice Address - Street 1:23 COURT PARK
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06119-2002
Practice Address - Country:US
Practice Address - Phone:860-385-1494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-17
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0065571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT006557OtherLCSW