Provider Demographics
NPI:1376639864
Name:BAILLIE, JOSEPH (LSW, CEAP)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:BAILLIE
Suffix:
Gender:M
Credentials:LSW, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1463 DUNWOODY DRIVE
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380
Mailing Address - Country:US
Mailing Address - Phone:610-644-6000
Mailing Address - Fax:610-644-1134
Practice Address - Street 1:1463 DUNWOODY DRIVE
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380
Practice Address - Country:US
Practice Address - Phone:610-644-6000
Practice Address - Fax:610-644-1134
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW002165E104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker