Provider Demographics
NPI:1265442263
Name:BAILEY, HERBERT (LSW)
Entity Type:Individual
Prefix:
First Name:HERBERT
Middle Name:
Last Name:BAILEY
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:268 LITTLE BRITAIN RD
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19362-9015
Mailing Address - Country:US
Mailing Address - Phone:717-548-4655
Mailing Address - Fax:
Practice Address - Street 1:1400 BLACKHORSE HILL RD
Practice Address - Street 2:
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320-2040
Practice Address - Country:US
Practice Address - Phone:610-384-7711
Practice Address - Fax:610-466-2203
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW003035E104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker