Provider Demographics
NPI:1861821241
Name:BAILEY, KRISHNA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KRISHNA
Middle Name:
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 1:104 MORNING GLORY LN
Mailing Address - Street 2:
Mailing Address - City:WESTWEGO
Mailing Address - State:LA
Mailing Address - Zip Code:70094-2276
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:104 MORNING GLORY LN
Practice Address - Street 2:
Practice Address - City:WESTWEGO
Practice Address - State:LA
Practice Address - Zip Code:70094-2276
Practice Address - Country:US
Practice Address - Phone:504-292-0633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA99991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical