Provider Demographics
NPI:1447085618
Name:BAYNES, HOLLY (MED, LMHCA)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:BAYNES
Suffix:
Gender:F
Credentials:MED, LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6102 W 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338-1509
Mailing Address - Country:US
Mailing Address - Phone:509-572-0241
Mailing Address - Fax:
Practice Address - Street 1:5428 W CLEARWATER AVE STE C
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-1905
Practice Address - Country:US
Practice Address - Phone:509-572-0241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61580582101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health