Provider Demographics
NPI:1275119844
Name:BAILEY, JAMIE (MS, LPCMH, LCPC, NCC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MS, LPCMH, LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N BROAD ST STE 5
Mailing Address - Street 2:PMB 2137
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709
Mailing Address - Country:US
Mailing Address - Phone:302-367-7259
Mailing Address - Fax:
Practice Address - Street 1:600 N BROAD ST STE 5
Practice Address - Street 2:PMB 2137
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709
Practice Address - Country:US
Practice Address - Phone:302-367-7259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-23
Last Update Date:2023-09-11
Deactivation Date:2022-02-16
Deactivation Code:
Reactivation Date:2022-12-23
Provider Licenses
StateLicense IDTaxonomies
DE101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health