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General NPI Number Information
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NPI Number | 1316749518
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Entity Type | Individual
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Provider Name | NICOLE DIANE BAYLIES LPC LCADC
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Gender | Female
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Dates
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Enumeration Date | 03/26/2025
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 32 S MAIN ST STE D
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City | MEDFORD
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State | NJ
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Zip | 08055-2455
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Country | US
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Telephone | 856-617-4544
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Fax |
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Provider Business Mailing Address
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Address Line | 68 EATON RD
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City | BORDENTOWN
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State | NJ
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Zip | 08505-2716
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Country | US
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Telephone | 609-668-0096
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 37LC00312200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00747400
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License Number State |
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