Provider Demographics
NPI:1366048761
Name:BAITY, JENNIFER E (LCSW, LAADC)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:E
Last Name:BAITY
Suffix:
Gender:F
Credentials:LCSW, LAADC
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:BAITY CARLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:60 29TH ST.
Mailing Address - Street 2:#629
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110
Mailing Address - Country:US
Mailing Address - Phone:415-873-9828
Mailing Address - Fax:
Practice Address - Street 1:32 LUNDYS LN.
Practice Address - Street 2:#7
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-5157
Practice Address - Country:US
Practice Address - Phone:415-873-9828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCI02780315101YA0400X
CA1041C0700X1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)