Provider Demographics
NPI:1760893648
Name:BAILEY, YOLANDA SUSAN RENEE (LCPC, CRC)
Entity Type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:SUSAN RENEE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LCPC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1376
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20768-1376
Mailing Address - Country:US
Mailing Address - Phone:202-906-0085
Mailing Address - Fax:202-544-6600
Practice Address - Street 1:11316 CHERRY HILL RD
Practice Address - Street 2:#201
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-3709
Practice Address - Country:US
Practice Address - Phone:202-906-0085
Practice Address - Fax:202-544-6600
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4127101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional