Provider Demographics
NPI:1124829908
Name:BAITY, SUZANNE (LSW)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:BAITY
Suffix:
Gender:
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28390 EVERETT RD
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81006-9645
Mailing Address - Country:US
Mailing Address - Phone:719-425-9005
Mailing Address - Fax:
Practice Address - Street 1:1277 KELLY JOHNSON BLVD STE 160
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3992
Practice Address - Country:US
Practice Address - Phone:719-257-3540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLSW.00099250201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical