Provider Demographics
NPI:1538513270
Name:BAILEY, CAITLIN (MED, LPC)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 CHUCKANUT LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-7301
Mailing Address - Country:US
Mailing Address - Phone:713-805-9214
Mailing Address - Fax:
Practice Address - Street 1:1001 WEST LOOP S STE 215
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-9082
Practice Address - Country:US
Practice Address - Phone:713-621-9515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-19
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72485101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional