Provider Demographics
NPI:1326557638
Name:BAILEY, STEPHEN WILLIAM (LMHC)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:WILLIAM
Last Name:BAILEY
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1901 TAYLOR AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-3130
Mailing Address - Country:US
Mailing Address - Phone:407-895-6448
Mailing Address - Fax:407-884-1309
Practice Address - Street 1:2431 ALOMA AVE STE 114
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-2541
Practice Address - Country:US
Practice Address - Phone:407-895-6448
Practice Address - Fax:407-884-1309
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-29
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL4618101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health