Provider Demographics
NPI:1184213472
Name:COLES, BAILLI LOUISE WHITE (LMSW)
Entity Type:Individual
Prefix:
First Name:BAILLI
Middle Name:LOUISE WHITE
Last Name:COLES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1443 N FULLER AVE APT 405
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90046-4268
Mailing Address - Country:US
Mailing Address - Phone:240-305-8775
Mailing Address - Fax:
Practice Address - Street 1:11301 WILSHIRE BLVD RM 211
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90073-1003
Practice Address - Country:US
Practice Address - Phone:310-478-3711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker