Provider Demographics
NPI:1326395609
Name:BAILEY, FAITH ANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:FAITH
Middle Name:ANN
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:269 LIGHTHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06512-4314
Mailing Address - Country:US
Mailing Address - Phone:203-606-9723
Mailing Address - Fax:
Practice Address - Street 1:269 LIGHTHOUSE RD
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06512-4314
Practice Address - Country:US
Practice Address - Phone:203-606-9723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-06
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT71901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical