Provider Demographics
NPI:1558592014
Name:BAILEY, CAROL A (LPC)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:A
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13515 MISTY DEW CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-4717
Mailing Address - Country:US
Mailing Address - Phone:803-516-2713
Mailing Address - Fax:
Practice Address - Street 1:13515 MISTY DEW CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-4717
Practice Address - Country:US
Practice Address - Phone:803-516-2713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-01
Last Update Date:2009-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3427101YP2500X
NC4617101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional