Provider Demographics
NPI:1952908006
Name:BAYNES, WARREN J SR (LMSW)
Entity type:Individual
Prefix:
First Name:WARREN
Middle Name:J
Last Name:BAYNES
Suffix:SR
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1537 SEYMOUR AVE
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-5013
Mailing Address - Country:US
Mailing Address - Phone:315-316-4182
Mailing Address - Fax:
Practice Address - Street 1:1537 SEYMOUR AVE
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-5013
Practice Address - Country:US
Practice Address - Phone:315-316-4182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY107881104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker