MEDICARE: SUZANNE BAITY LSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LSW.0009925020	CO

General Provider Information

NPI Number	:	1124829908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE BAITY LSW

Provider Business Mailing Address
First Line	:	28390 EVERETT RD
Second Line	:
City	:	PUEBLO
State	:	CO
Zip	:	81006-9645
Country	:	US
Telephone Number	:	719-425-9005
Fax Number	:

Provider Business Practice Location Address
First Line	:	1277 KELLY JOHNSON BLVD STE 160
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-3992
Country	:	US
Telephone Number	:	719-257-3540
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2025
Last Update Date	:	03/19/2025

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Directions to “ SUZANNE BAITY LSW” Practice Location

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