Provider Demographics
NPI:1578390878
Name:BAYNES, KRISTY LEIGH
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:LEIGH
Last Name:BAYNES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3110 GRAND AVE APT 1214
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33782-6154
Mailing Address - Country:US
Mailing Address - Phone:570-479-2691
Mailing Address - Fax:
Practice Address - Street 1:3110 GRAND AVE APT 1214
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33782-6154
Practice Address - Country:US
Practice Address - Phone:570-479-2691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)