Provider Demographics
NPI:1811595697
Name:BAILEY, SARAH NICOLE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:NICOLE
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 1:27759 ROCK AVE
Mailing Address - Street 2:
Mailing Address - City:BELL CITY
Mailing Address - State:MO
Mailing Address - Zip Code:63735-8111
Mailing Address - Country:US
Mailing Address - Phone:573-887-1049
Mailing Address - Fax:
Practice Address - Street 1:27759 ROCK AVE
Practice Address - Street 2:
Practice Address - City:BELL CITY
Practice Address - State:MO
Practice Address - Zip Code:63735-8111
Practice Address - Country:US
Practice Address - Phone:573-887-1049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20170395891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical