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Individual
MS. ILENE LILLIAN BAYER
Active
Individual
MS. ILENE LILLIAN BAYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C007611
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12388384
CAQH
NC
05
—
6007433
—
NC
01
—
Q39633A
MEDICARE PTAN
NC
Enumeration date
01/23/2012
Last updated
05/23/2013
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