Individual
DEREK BAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, NCC, LPC
Contact information
Practice address
1283 KELLY JOHNSON BLVD, COLORADO SPRINGS, CO 80920-3925
(719) 452-4803
Mailing address
5009 HAWK MEADOW DR, COLORADO SPRINGS, CO 80916-5729
(719) 464-3179
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC.0018940
CO
101YM0800X
Mental Health Counselor
LPC.0018940
CO
101YM0800X
Mental Health Counselor
LPCC.0018053
CO
Other
Enumeration date
02/17/2021
Last updated
05/24/2023
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