Individual
SUSAN CAROL BAISDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.; PH.D.
Contact information
Practice address
41 W 5TH AVE, WILLIAMSON, WV 25661-3201
(304) 235-3390
(304) 235-3391
Mailing address
41 W 5TH AVE, WILLIAMSON, WV 25661-3201
(304) 235-3390
(304) 235-3391
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
538
WV
103TC0700X
Clinical Psychologist
Primary
403
WV
1041C0700X
Clinical Social Worker
CP00452669
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0163475000
—
WV
Enumeration date
07/29/2005
Last updated
03/04/2024
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