Provider Demographics
NPI:1073772869
Name:BAILEY, KATHLEEN PARKER (MA, CPC-I)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:PARKER
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MA, CPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3435 W CRAIG RD SUITE A
Mailing Address - Street 2:ALLIANCE FAMILY SERVICES
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-5115
Mailing Address - Country:US
Mailing Address - Phone:702-750-0377
Mailing Address - Fax:702-538-7928
Practice Address - Street 1:3435 W CRAIG RD
Practice Address - Street 2:SUITE A
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-5115
Practice Address - Country:US
Practice Address - Phone:702-750-0377
Practice Address - Fax:702-538-7928
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCI0043101YP2500X
WARC00060241390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program