Provider Demographics
NPI:1801289327
Name:BAILEY, KARLA (PSYD)
Entity type:Individual
Prefix:DR
First Name:KARLA
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:KARLA
Other - Middle Name:BAILEY
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:4867 PLUM RUN CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-1715
Mailing Address - Country:US
Mailing Address - Phone:301-275-0225
Mailing Address - Fax:855-477-4383
Practice Address - Street 1:5155 W WOODMILL DR
Practice Address - Street 2:SUITE 17
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-4067
Practice Address - Country:US
Practice Address - Phone:301-275-0225
Practice Address - Fax:855-477-4383
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-09
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB1-0000964103TB0200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral