Provider Demographics
NPI:1174514426
Name:BAYARD, KAREN SUE (LCSW QCSW)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:SUE
Last Name:BAYARD
Suffix:
Gender:F
Credentials:LCSW QCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 KUEHU ST
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-4500
Mailing Address - Country:US
Mailing Address - Phone:808-260-9844
Mailing Address - Fax:808-260-9920
Practice Address - Street 1:404 KUEHU ST
Practice Address - Street 2:ATTN: OPENING DOORS TO CHANGE, LLC
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-4500
Practice Address - Country:US
Practice Address - Phone:808-260-9844
Practice Address - Fax:808-260-9920
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-03
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI32971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical