Provider Demographics
NPI:1407496342
Name:FEAKIN, BAILEY (LMHC, QMHP)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:
Last Name:FEAKIN
Suffix:
Gender:F
Credentials:LMHC, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2370 GABLE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT HELENS
Mailing Address - State:OR
Mailing Address - Zip Code:97051-2913
Mailing Address - Country:US
Mailing Address - Phone:503-397-4651
Mailing Address - Fax:
Practice Address - Street 1:2370 GABLE RD
Practice Address - Street 2:
Practice Address - City:SAINT HELENS
Practice Address - State:OR
Practice Address - Zip Code:97051-2913
Practice Address - Country:US
Practice Address - Phone:503-397-4651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-08
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health