Provider Demographics
NPI:1073875662
Name:BAILEY-BROOKS, MARCIA QUINLAIND (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:QUINLAIND
Last Name:BAILEY-BROOKS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:M
Other - Middle Name:QUEEN
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:2777 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30168-4054
Mailing Address - Country:US
Mailing Address - Phone:678-831-2810
Mailing Address - Fax:
Practice Address - Street 1:2777 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30168-4054
Practice Address - Country:US
Practice Address - Phone:678-831-2810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-11
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0041171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical