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General NPI Number Information
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NPI Number | 1407508401
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Entity Type | Individual
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Provider Name | JEFFREY ALLEN BAYNE MS, NCC
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Gender | Male
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Dates
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Enumeration Date | 01/20/2022
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Last Update Date | 01/20/2022
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Provider Practice Location Address
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Address Line | 3505 ADKISSON DR NW STE 165
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City | CLEVELAND
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State | TN
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Zip | 37312-6807
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Country | US
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Telephone | 423-715-3904
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Fax | 423-473-6712
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Provider Business Mailing Address
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Address Line | 3505 ADKISSON DR NW STE 165
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City | CLEVELAND
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State | TN
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Zip | 37312-6807
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Country | US
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Telephone | 423-715-3904
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Fax | 423-473-6712
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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