Provider Demographics
NPI:1144635665
Name:BAIRD & ASSOCIATES PROFESSIONAL COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:BAIRD & ASSOCIATES PROFESSIONAL COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:DAIGLE
Authorized Official - Last Name:BAIRD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S, LAC, NCC
Authorized Official - Phone:318-226-1555
Mailing Address - Street 1:2620 CENTENARY BLVD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71104-3356
Mailing Address - Country:US
Mailing Address - Phone:318-226-1555
Mailing Address - Fax:318-226-0406
Practice Address - Street 1:2620 CENTENARY BLVD
Practice Address - Street 2:SUITE 304
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71104-3356
Practice Address - Country:US
Practice Address - Phone:318-226-1555
Practice Address - Fax:318-226-0406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1255101YA0400X
LA298252101YP2500X
LA3745101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA600915934Medicaid