Provider Demographics
NPI:1952656886
Name:BAILEY, KAITLIN FRANCES (BA)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:FRANCES
Last Name:BAILEY
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:557 FRUIT HILL AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02911-2134
Mailing Address - Country:US
Mailing Address - Phone:401-353-0369
Mailing Address - Fax:
Practice Address - Street 1:44 FRONT ST
Practice Address - Street 2:SUITE 490
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1733
Practice Address - Country:US
Practice Address - Phone:508-799-2934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)