Provider Demographics
NPI:1154531226
Name:BAILEY, ROCHELLE RENEE (LCSW)
Entity type:Individual
Prefix:MS
First Name:ROCHELLE
Middle Name:RENEE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ROCHELLE
Other - Middle Name:RENEE
Other - Last Name:REYNOLDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:4045 NW 64TH ST
Mailing Address - Street 2:SUITE 520
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-1684
Mailing Address - Country:US
Mailing Address - Phone:405-842-4911
Mailing Address - Fax:
Practice Address - Street 1:4045 NW 64TH ST
Practice Address - Street 2:SUITE 520
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-1684
Practice Address - Country:US
Practice Address - Phone:405-842-4911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6297T104100000X
OK4820101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker