Provider Demographics
NPI:1285033415
Name:BLEDSOE, BAILEY (LPC)
Entity Type:Individual
Prefix:MRS
First Name:BAILEY
Middle Name:
Last Name:BLEDSOE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:BAILEY
Other - Middle Name:
Other - Last Name:GOLDBERGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:5180 CAMPBELLS RUN RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205-9731
Mailing Address - Country:US
Mailing Address - Phone:412-788-8219
Mailing Address - Fax:412-788-8215
Practice Address - Street 1:5180 CAMPBELLS RUN RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-9731
Practice Address - Country:US
Practice Address - Phone:412-788-8219
Practice Address - Fax:412-788-8215
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-13
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006418101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional