Provider Demographics
NPI:1083253322
Name:BAYNARD, KRISTIN DESLAURIERS (LPCMH)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:DESLAURIERS
Last Name:BAYNARD
Suffix:
Gender:
Credentials:LPCMH
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:DESLAURIERS
Other - Last Name:BRAUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1515 SAVANNAH RD
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1675
Mailing Address - Country:US
Mailing Address - Phone:302-645-3499
Mailing Address - Fax:
Practice Address - Street 1:33664 BAYVIEW DRIVE
Practice Address - Street 2:UNIT 203
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1933
Practice Address - Country:US
Practice Address - Phone:302-645-1099
Practice Address - Fax:302-645-0130
Is Sole Proprietor?:No
Enumeration Date:2020-01-03
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701008766101YA0400X, 101YM0800X
DEPC-0011541101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)