Provider Demographics
NPI:1982835310
Name:BAILEY, KIRA ANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KIRA
Middle Name:ANN
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 1:3501 N 19TH ST
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76708-2007
Mailing Address - Country:US
Mailing Address - Phone:254-745-5378
Mailing Address - Fax:
Practice Address - Street 1:3501 N 19TH ST
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76708-2007
Practice Address - Country:US
Practice Address - Phone:254-745-5378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-03
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX375761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical