Provider Demographics
NPI:1659385805
Name:BAILEY, SHARON FELICIA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:FELICIA
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2118 N MAIN AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-5851
Mailing Address - Country:US
Mailing Address - Phone:210-355-8923
Mailing Address - Fax:219-659-0806
Practice Address - Street 1:2118 N MAIN AVE
Practice Address - Street 2:STE 101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-5851
Practice Address - Country:US
Practice Address - Phone:210-355-8923
Practice Address - Fax:219-659-0806
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX184641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX610946Medicare ID - Type Unspecified