Provider Demographics
NPI:1841777844
Name:CRAMER, BAYLEA (LPC)
Entity type:Individual
Prefix:
First Name:BAYLEA
Middle Name:
Last Name:CRAMER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:BAYLEA
Other - Middle Name:
Other - Last Name:WAGENER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 61226
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78466-1226
Mailing Address - Country:US
Mailing Address - Phone:361-442-4024
Mailing Address - Fax:361-853-7877
Practice Address - Street 1:5959 S STAPLES ST STE 200
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-3844
Practice Address - Country:US
Practice Address - Phone:361-442-4024
Practice Address - Fax:361-806-9491
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-23
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74875101YP2500X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1841777844Medicaid
TX74875OtherLICENSED PROFESSIONAL COUNSELOR LICENSE