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NPI Code Detail

MEDICARE: COLLEEN W BAIRD LPC

MEDICARE: COLLEEN W BAIRD LPC
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
1101YP2500XProfessional Counselor5998WI

General Provider Information

NPI Number : 1578018529
Entity Type Code : Individual
Provider Name (Legal Business Name) : COLLEEN W BAIRD LPC
Provider Business Mailing Address
First Line : 5450 N LYDELL AVE
Second Line :
City : WHITEFISH BAY
State : WI
Zip : 53217-5005
Country : US
Telephone Number : 608-692-1254
Fax Number :
Provider Business Practice Location Address
First Line : 5555 N PORT WASHINGTON RD STE 200
Second Line :
City : GLENDALE
State : WI
Zip : 53217-4927
Country : US
Telephone Number : 262-789-1191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2016
Last Update Date : 02/05/2024

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