Provider Demographics
NPI:1346713385
Name:BAILEY, LUCY P
Entity Type:Individual
Prefix:
First Name:LUCY
Middle Name:P
Last Name:BAILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LUCY
Other - Middle Name:PRISCILLA
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CSW
Mailing Address - Street 1:189 S STATE ST STE 250
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84015-1100
Mailing Address - Country:US
Mailing Address - Phone:385-423-2377
Mailing Address - Fax:385-423-2379
Practice Address - Street 1:189 S STATE ST STE 250
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:UT
Practice Address - Zip Code:84015-1100
Practice Address - Country:US
Practice Address - Phone:385-423-2377
Practice Address - Fax:385-423-2379
Is Sole Proprietor?:No
Enumeration Date:2019-01-02
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT171M00000X
UT5185530-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator