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General NPI Number Information
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NPI Number | 1417522814
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Entity Type | Individual
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Provider Name | JESSICA MARY BAIRD MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 05/26/2021
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Last Update Date | 05/26/2021
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Provider Practice Location Address
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Address Line | 150 E 29TH ST STE 237
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City | LOVELAND
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State | CO
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Zip | 80538-2765
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Country | US
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Telephone | 970-518-1926
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Fax |
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Provider Business Mailing Address
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Address Line | 336 CAMINO DEL MUNDO
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City | FORT COLLINS
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State | CO
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Zip | 80524-8945
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Country | US
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Telephone | 970-631-1478
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC.0017171
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License Number State | CO
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