Provider Demographics
NPI:1568290807
Name:BAIRD, AMY KAY (LCSW)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:KAY
Last Name:BAIRD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2907 NW SQUIRE ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-1081
Mailing Address - Country:US
Mailing Address - Phone:541-979-4499
Mailing Address - Fax:
Practice Address - Street 1:2907 NW SQUIRE ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-1081
Practice Address - Country:US
Practice Address - Phone:541-979-4499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-25
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL63571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical