Provider Demographics
NPI:1407354301
Name:BAILEY, JOANNA H (BCBA)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:H
Last Name:BAILEY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 E CARY ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-7024
Mailing Address - Country:US
Mailing Address - Phone:804-215-5600
Mailing Address - Fax:804-800-9329
Practice Address - Street 1:1717 E CARY ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-7024
Practice Address - Country:US
Practice Address - Phone:804-215-5600
Practice Address - Fax:804-800-9329
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-25
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORABA-B-10201031103K00000X
WABA60982763103K00000X
106S00000X
VA0133004372103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician