Provider Demographics
NPI:1487226155
Name:GRIFFIN, BAILEY JO (LMSW, CSW INTERN)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:JO
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:LMSW, CSW INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 E LONG ST
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-2505
Mailing Address - Country:US
Mailing Address - Phone:775-461-0025
Mailing Address - Fax:
Practice Address - Street 1:119 E LONG ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-2505
Practice Address - Country:US
Practice Address - Phone:775-461-0025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVIC-17561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical