Provider Demographics
NPI:1558754333
Name:BAILEY, JOCELIN (LICSW)
Entity Type:Individual
Prefix:
First Name:JOCELIN
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 BENNING RD SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-6145
Mailing Address - Country:US
Mailing Address - Phone:202-553-2395
Mailing Address - Fax:202-582-4680
Practice Address - Street 1:4801 BENNING RD SE
Practice Address - Street 2:KIPP DC
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019
Practice Address - Country:US
Practice Address - Phone:202-553-2395
Practice Address - Fax:202-582-4680
Is Sole Proprietor?:No
Enumeration Date:2015-03-18
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500791851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical