Provider Demographics
NPI:1659732808
Name:BAILEY, JAIME (PSYD, LPC)
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:PSYD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 VETERANS AVE UNIT 106
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53090-2559
Mailing Address - Country:US
Mailing Address - Phone:262-353-4460
Mailing Address - Fax:262-353-4461
Practice Address - Street 1:611 VETERANS AVE
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53090-2545
Practice Address - Country:US
Practice Address - Phone:262-353-4460
Practice Address - Fax:262-353-4461
Is Sole Proprietor?:No
Enumeration Date:2016-03-16
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6109-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional