Provider Demographics
NPI:1881008506
Name:BAILEY, LINDSAY PIETRUCK (MSW, LMSW)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:PIETRUCK
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 S MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-6432
Mailing Address - Country:US
Mailing Address - Phone:734-786-2626
Mailing Address - Fax:
Practice Address - Street 1:2100 S MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-6432
Practice Address - Country:US
Practice Address - Phone:734-786-2626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-20
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010946021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical