Provider Demographics
NPI:1356522932
Name:BAILEY & ASSOCIATES PSC
Entity type:Organization
Organization Name:BAILEY & ASSOCIATES PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCSW
Authorized Official - Phone:502-327-0209
Mailing Address - Street 1:9700 PARK PLAZA AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-2236
Mailing Address - Country:US
Mailing Address - Phone:502-327-0209
Mailing Address - Fax:502-426-4902
Practice Address - Street 1:9700 PARK PLAZA AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-2236
Practice Address - Country:US
Practice Address - Phone:502-327-0209
Practice Address - Fax:502-426-4902
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAILEY & ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-24
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY78519103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1255309530OtherNPI
KY1255309530OtherNPI
KY0954901Medicare PIN