Provider Demographics
NPI:1851883938
Name:BAILEY, CHANDRA DIONNE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:CHANDRA
Middle Name:DIONNE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6406 E BANES CT
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-8247
Mailing Address - Country:US
Mailing Address - Phone:804-683-5919
Mailing Address - Fax:804-781-4967
Practice Address - Street 1:6406 E BANES CT
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-8247
Practice Address - Country:US
Practice Address - Phone:804-683-5919
Practice Address - Fax:804-781-4967
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-04
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006862101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty