MEDICARE: ANDREA LOFTUS BAYLEY LCSW

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	006557	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	006557	OTHER	CT	LCSW

General Provider Information

NPI Number	:	1740476498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA LOFTUS BAYLEY LCSW

Provider Business Mailing Address
First Line	:	23 COURT PARK
Second Line	:
City	:	WEST HARTFORD
State	:	CT
Zip	:	06119-2002
Country	:	US
Telephone Number	:	860-385-1494
Fax Number	:

Provider Business Practice Location Address
First Line	:	23 COURT PARK
Second Line	:
City	:	WEST HARTFORD
State	:	CT
Zip	:	06119-2002
Country	:	US
Telephone Number	:	860-385-1494
Fax Number	:

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

Provider Enumeration Date	:	09/17/2007
Last Update Date	:	12/14/2021

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