Provider Demographics
NPI:1366339129
Name:BAXTER-SMITH, BAYN D (MS, LAC)
Entity type:Individual
Prefix:MRS
First Name:BAYN
Middle Name:D
Last Name:BAXTER-SMITH
Suffix:
Gender:F
Credentials:MS, LAC
Other - Prefix:MRS
Other - First Name:BAYN
Other - Middle Name:D
Other - Last Name:BAXTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4662 E BEVERLY LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-3409
Mailing Address - Country:US
Mailing Address - Phone:617-359-4530
Mailing Address - Fax:
Practice Address - Street 1:2346 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-1329
Practice Address - Country:US
Practice Address - Phone:602-234-1935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-23299101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health