Provider Demographics
NPI:1588809479
Name:LANIER, BAILEY DEJARNETTE (LPC)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:DEJARNETTE
Last Name:LANIER
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 1:371 OAKDALE CIR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-7348
Mailing Address - Country:US
Mailing Address - Phone:434-237-4422
Mailing Address - Fax:
Practice Address - Street 1:371 OAKDALE CIR
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-7348
Practice Address - Country:US
Practice Address - Phone:434-237-4422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-08
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004482101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1437137734Medicaid