Provider Demographics
NPI:1730056946
Name:GRAY-BAILEY, VICTORIA L
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:L
Last Name:GRAY-BAILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 MOORE DR
Mailing Address - Street 2:
Mailing Address - City:BERRYVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22611-1149
Mailing Address - Country:US
Mailing Address - Phone:703-213-7453
Mailing Address - Fax:
Practice Address - Street 1:1043 EDWARDS FERRY RD NE # 17
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-3347
Practice Address - Country:US
Practice Address - Phone:703-213-7453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA11178101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty