Healthcare Provider Details

I. General information

NPI: 1083253322
Provider Name (Legal Business Name): KRISTIN DESLAURIERS BAYNARD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTIN DESLAURIERS BRAUN

II. Dates (important events)

Enumeration Date: 01/03/2020
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33664 BAYVIEW MEDICAL DR STE 203
LEWES DE
19958-1933
US

IV. Provider business mailing address

1515 SAVANNAH RD
LEWES DE
19958-1675
US

V. Phone/Fax

Practice location:
  • Phone: 302-645-1099
  • Fax: 302-645-0130
Mailing address:
  • Phone: 302-645-3499
  • Fax: 302-644-4830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701008766
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0701008766
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPC-0011541
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: