Provider Demographics
NPI:1710539952
Name:LASCESKI, BAILEY LYNN
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:LYNN
Last Name:LASCESKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12235 PALATIAL DR
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:MI
Mailing Address - Zip Code:48623-8714
Mailing Address - Country:US
Mailing Address - Phone:989-553-3888
Mailing Address - Fax:
Practice Address - Street 1:401 CENTER AVE STE 30
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-5912
Practice Address - Country:US
Practice Address - Phone:989-553-3888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-09
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
MI104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician