Provider Demographics
NPI:1821358276
Name:BAILEY, MARCYLINE LUCIOUS (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARCYLINE
Middle Name:LUCIOUS
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 1:103 CHERRYWOOD CT
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31525-8590
Mailing Address - Country:US
Mailing Address - Phone:912-270-2687
Mailing Address - Fax:
Practice Address - Street 1:11 TRADE ST 107
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31525-1914
Practice Address - Country:US
Practice Address - Phone:912-217-6742
Practice Address - Fax:912-480-9697
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-19
Last Update Date:2015-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0022011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical