Provider Demographics
NPI:1922510031
Name:BAILEY, REGINA LEIGH (MS, CADC-I)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:LEIGH
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MS, CADC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:980 HOLLANDSWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-5301
Mailing Address - Country:US
Mailing Address - Phone:702-810-5692
Mailing Address - Fax:
Practice Address - Street 1:2575 MONTESSOURI ST STE 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-3060
Practice Address - Country:US
Practice Address - Phone:702-506-7846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-30
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV02211-I101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)