Provider Demographics
NPI:1669778395
Name:GREY, BAILEY JOLYNN (LMSW)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:JOLYNN
Last Name:GREY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:VALLEY FALLS
Mailing Address - State:KS
Mailing Address - Zip Code:66088
Mailing Address - Country:US
Mailing Address - Phone:785-231-8566
Mailing Address - Fax:
Practice Address - Street 1:235 S. KANSAS AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66603
Practice Address - Country:US
Practice Address - Phone:785-409-6801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-27
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS9542104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker