Provider Demographics
NPI:1043000607
Name:BAILEY, KEISHAWNA (MSW)
Entity type:Individual
Prefix:
First Name:KEISHAWNA
Middle Name:
Last Name:BAILEY
Suffix:
Gender:
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 JULIE LN
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-3005
Mailing Address - Country:US
Mailing Address - Phone:470-698-1762
Mailing Address - Fax:
Practice Address - Street 1:108 JULIE LN
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-3005
Practice Address - Country:US
Practice Address - Phone:470-698-1762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker