Provider Demographics
NPI:1396438339
Name:KRISTIN BAILEY THERAPY LLC
Entity type:Organization
Organization Name:KRISTIN BAILEY THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:479-647-0300
Mailing Address - Street 1:211 W WALNUT ST STE 201-B
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-6664
Mailing Address - Country:US
Mailing Address - Phone:479-647-0300
Mailing Address - Fax:
Practice Address - Street 1:211 W WALNUT ST STE 201-B
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-6664
Practice Address - Country:US
Practice Address - Phone:479-647-0300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)