Provider Demographics
NPI:1740983196
Name:BAILEY, SHERRY (LGSW)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CROSSWIND DR
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-9118
Mailing Address - Country:US
Mailing Address - Phone:304-363-2228
Mailing Address - Fax:
Practice Address - Street 1:10 CROSSWIND DR
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-9118
Practice Address - Country:US
Practice Address - Phone:304-296-1731
Practice Address - Fax:304-363-2282
Is Sole Proprietor?:No
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVBP00946050104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker