Provider Demographics
NPI:1467807172
Name:MACLEOD, BAILEY (PHD)
Entity Type:Individual
Prefix:DR
First Name:BAILEY
Middle Name:
Last Name:MACLEOD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 NORTHEAST DR STE 20
Mailing Address - Street 2:
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28036-7425
Mailing Address - Country:US
Mailing Address - Phone:980-272-1498
Mailing Address - Fax:
Practice Address - Street 1:709 NORTHEAST DR STE 20
Practice Address - Street 2:
Practice Address - City:DAVIDSON
Practice Address - State:NC
Practice Address - Zip Code:28036-7425
Practice Address - Country:US
Practice Address - Phone:863-604-1450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-01
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA10862101YM0800X
101YA0400X
NC10862101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)