Provider Demographics
NPI:1407420888
Name:HOGAN, BAILEY RASHELLE (MSW)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:RASHELLE
Last Name:HOGAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:BAILEY
Other - Middle Name:RASHELLE
Other - Last Name:RICHEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6655 E US HIGHWAY 36
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-8923
Mailing Address - Country:US
Mailing Address - Phone:888-714-1927
Mailing Address - Fax:
Practice Address - Street 1:1928 S DAN JONES RD
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-6678
Practice Address - Country:US
Practice Address - Phone:317-854-8265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
IN34010549A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker