Provider Demographics
NPI:1255905329
Name:BAILEY, JAMES
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:BAILEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 W 100 S APT 474
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84101-1992
Mailing Address - Country:US
Mailing Address - Phone:225-250-6295
Mailing Address - Fax:
Practice Address - Street 1:5784 S 900 E # 6
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84121-1689
Practice Address - Country:US
Practice Address - Phone:385-274-7064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-13
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12056237-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical