Provider Demographics
NPI:1073836771
Name:KAROL A BAILEY, PH.D., A PROFESSIONAL PSYCHOLOGICAL CORPORATION
Entity Type:Organization
Organization Name:KAROL A BAILEY, PH.D., A PROFESSIONAL PSYCHOLOGICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAROL
Authorized Official - Middle Name:A
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:562-431-3423
Mailing Address - Street 1:6475 E PACIFIC COAST HWY
Mailing Address - Street 2:#414
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-4201
Mailing Address - Country:US
Mailing Address - Phone:562-431-3423
Mailing Address - Fax:
Practice Address - Street 1:212 MAIN ST STE A3
Practice Address - Street 2:
Practice Address - City:SEAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:90740-6378
Practice Address - Country:US
Practice Address - Phone:562-431-3423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health