Provider Demographics
NPI:1184666240
Name:BAILEY, NANCY ANN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:ANN
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 N LAFAYETTE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150-3978
Mailing Address - Country:US
Mailing Address - Phone:704-284-0554
Mailing Address - Fax:704-448-2003
Practice Address - Street 1:809 N LAFAYETTE ST
Practice Address - Street 2:SUITE A
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-3978
Practice Address - Country:US
Practice Address - Phone:704-284-0554
Practice Address - Fax:704-448-2003
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3588101YP2500X
SC1963101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102629Medicaid
NC137C6OtherBC/BS PIN NUMBER