Provider Demographics
NPI:1750606414
Name:BAYARD, MARK ALEXANDER (LMHCRI)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:ALEXANDER
Last Name:BAYARD
Suffix:
Gender:M
Credentials:LMHCRI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6790 85TH ST
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32967-4619
Mailing Address - Country:US
Mailing Address - Phone:321-482-6016
Mailing Address - Fax:
Practice Address - Street 1:6790 85TH ST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32967-4619
Practice Address - Country:US
Practice Address - Phone:321-482-6016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health