Provider Demographics
NPI:1477951598
Name:STEPHEN W. BAILEY,LMHC, PA
Entity Type:Organization
Organization Name:STEPHEN W. BAILEY,LMHC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:407-895-6448
Mailing Address - Street 1:1901 TAYLOR AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-3130
Mailing Address - Country:US
Mailing Address - Phone:407-895-6448
Mailing Address - Fax:407-884-1309
Practice Address - Street 1:1035 S SEMORAN BLVD
Practice Address - Street 2:SUITE 1027
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-5526
Practice Address - Country:US
Practice Address - Phone:407-895-6448
Practice Address - Fax:407-884-1309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-06
Last Update Date:2014-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4618101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty