Provider Demographics
NPI:1750587796
Name:MCADAMS, BAILEY NICOLE (MED, LPC)
Entity type:Individual
Prefix:MS
First Name:BAILEY
Middle Name:NICOLE
Last Name:MCADAMS
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3914 BRYCE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-4419
Mailing Address - Country:US
Mailing Address - Phone:940-300-4096
Mailing Address - Fax:
Practice Address - Street 1:5009 THOMPSON TER
Practice Address - Street 2:SUITE 103
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-5850
Practice Address - Country:US
Practice Address - Phone:817-800-0996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61587101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor