Provider Demographics
NPI:1255309530
Name:BAILEY, LINDA (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9700 PARK PLAZA AVE
Mailing Address - Street 2:STE 105
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-2286
Mailing Address - Country:US
Mailing Address - Phone:502-327-0209
Mailing Address - Fax:502-426-4902
Practice Address - Street 1:9700 PARK PLAZA AVE
Practice Address - Street 2:STE 105
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-2286
Practice Address - Country:US
Practice Address - Phone:502-327-0209
Practice Address - Fax:502-426-4902
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY78519103T00000X
KY361104100000X
KY0308106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist