Baisden, Susan Carol

Baisden, Susan Carol is an individual health care provider with primary practice located at 41 W 5Th Ave , Williamson WV 25661-3201. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Baisden, Susan Carol can be contacted via phone (304) 235-3390.

Contact Information

Primary practice address
41 W 5Th Ave Williamson WV 25661-3201
Phone: (304) 235-3390
Fax: (304) 235-3391
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 538 West Virginia
Behavioral Health & Social Service Providers / Clinical 103TC0700X 403 West Virginia
Behavioral Health & Social Service Providers / Clinical 1041C0700X CP00452669 West Virginia

Profile Details

NPI number 1558361527
LBN Legal business name Baisden, Susan Carol
Credentials M.S.; PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2005
Last updated Mar 4th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558361527 NPPES
West Virginia MEDICAID 0163475000

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