Provider Demographics
NPI:1255464566
Name:BAILEY, EMILY ELIZABETH (LPC)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:ELIZABETH
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:ELIZABETH
Other - Last Name:MAYNOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:342 BURROW LN
Mailing Address - Street 2:
Mailing Address - City:COTTON VALLEY
Mailing Address - State:LA
Mailing Address - Zip Code:71018-2932
Mailing Address - Country:US
Mailing Address - Phone:183-510-4784
Mailing Address - Fax:
Practice Address - Street 1:7505 PINES RD STE 1115
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71129-3900
Practice Address - Country:US
Practice Address - Phone:318-683-4086
Practice Address - Fax:318-623-4087
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6385101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor