Provider Demographics
NPI:1053780775
Name:O'BRIEN, BAYLEE
Entity type:Individual
Prefix:
First Name:BAYLEE
Middle Name:
Last Name:O'BRIEN
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 1:1316 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLARION
Mailing Address - State:IA
Mailing Address - Zip Code:50525-2019
Mailing Address - Country:US
Mailing Address - Phone:515-532-2811
Mailing Address - Fax:319-343-1161
Practice Address - Street 1:1089 JORDAN CREEK PKWY
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-5829
Practice Address - Country:US
Practice Address - Phone:515-327-2000
Practice Address - Fax:515-327-2019
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-23
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0782851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical