Provider Demographics
NPI:1740871649
Name:BAILEY, ALYSON (MS, LMHC)
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:ALYSON
Other - Middle Name:
Other - Last Name:HICKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LMHC
Mailing Address - Street 1:13674 W HILLSBOROUGH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33635-9638
Mailing Address - Country:US
Mailing Address - Phone:813-851-3927
Mailing Address - Fax:954-827-6467
Practice Address - Street 1:13674 W HILLSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33635-9638
Practice Address - Country:US
Practice Address - Phone:813-851-3927
Practice Address - Fax:954-827-6467
Is Sole Proprietor?:No
Enumeration Date:2021-02-02
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH22093101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health