Provider Demographics
NPI:1801940713
Name:BAITY, VICKI C (LCSW)
Entity type:Individual
Prefix:
First Name:VICKI
Middle Name:C
Last Name:BAITY
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 EBENEZER RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-5310
Mailing Address - Country:US
Mailing Address - Phone:865-919-0101
Mailing Address - Fax:865-670-1991
Practice Address - Street 1:325 EBENEZER RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-5310
Practice Address - Country:US
Practice Address - Phone:865-919-0101
Practice Address - Fax:865-670-1991
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2025-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000004201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3691482Medicaid
TN3691482Medicare ID - Type Unspecified