Provider Demographics
NPI:1780898221
Name:BAILEY, V MICHELA (MA, LPC)
Entity type:Individual
Prefix:MS
First Name:V MICHELA
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 31546
Mailing Address - Street 2:
Mailing Address - City:DES PERES
Mailing Address - State:MO
Mailing Address - Zip Code:63131-0546
Mailing Address - Country:US
Mailing Address - Phone:314-471-9663
Mailing Address - Fax:636-527-9556
Practice Address - Street 1:140 PROSPECT AVE STE M
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-6024
Practice Address - Country:US
Practice Address - Phone:314-471-9663
Practice Address - Fax:636-527-9556
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCS002792101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional