Provider Demographics
NPI:1487888400
Name:BAYLARD-EIDSON, CARRIE (LPC)
Entity type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:
Last Name:BAYLARD-EIDSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:DR
Other - First Name:CARRIE
Other - Middle Name:
Other - Last Name:BAYLARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:5020 S MAPLE BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-0699
Mailing Address - Country:US
Mailing Address - Phone:816-863-6518
Mailing Address - Fax:
Practice Address - Street 1:266 NE BAYVIEW DR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-1597
Practice Address - Country:US
Practice Address - Phone:816-863-6518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005012736101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional