Provider Demographics
NPI:1417781972
Name:BAYUK, JESSICA (MED, LGPC, NCC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:BAYUK
Suffix:
Gender:F
Credentials:MED, LGPC, NCC
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:NAYLON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED, LGPC, NCC
Mailing Address - Street 1:8109 ASPENWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:JESSUP
Mailing Address - State:MD
Mailing Address - Zip Code:20794-8910
Mailing Address - Country:US
Mailing Address - Phone:240-405-7134
Mailing Address - Fax:
Practice Address - Street 1:60 MARKET ST STE 213
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-6559
Practice Address - Country:US
Practice Address - Phone:240-248-9626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP15498101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor