Provider Demographics
NPI:1407492986
Name:BAILEY, VICTOR LEON (MASTERS IN EDUCATION)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:LEON
Last Name:BAILEY
Suffix:
Gender:M
Credentials:MASTERS IN EDUCATION
Other - Prefix:
Other - First Name:VICTOR
Other - Middle Name:LEON
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:VICTOR L BAILEY MED
Mailing Address - Street 1:201 W SPRINGDALE AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-5158
Mailing Address - Country:US
Mailing Address - Phone:865-637-9711
Mailing Address - Fax:
Practice Address - Street 1:310 W 3RD NORTH ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-4038
Practice Address - Country:US
Practice Address - Phone:423-581-4761
Practice Address - Fax:423-581-2484
Is Sole Proprietor?:No
Enumeration Date:2019-11-20
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor