Provider Demographics
NPI:1952644940
Name:MCDONALD, BAILEY CREECH (LISW-CP)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:CREECH
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 PINE FOREST DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-4423
Mailing Address - Country:US
Mailing Address - Phone:864-248-6012
Mailing Address - Fax:
Practice Address - Street 1:250 S PLEASANTBURG DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-2522
Practice Address - Country:US
Practice Address - Phone:864-248-6012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC61511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical