Provider Demographics
NPI:1033787882
Name:BAILEY, JAZZMIN (MS, NCC, APC)
Entity Type:Individual
Prefix:MRS
First Name:JAZZMIN
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MS, NCC, APC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5520 GLORE DR SW
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-2421
Mailing Address - Country:US
Mailing Address - Phone:770-366-1035
Mailing Address - Fax:
Practice Address - Street 1:707 WHITLOCK AVE SW STE H10
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-3098
Practice Address - Country:US
Practice Address - Phone:470-568-2194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health