Provider Demographics
NPI:1811135106
Name:BAILEY, HEIDI VIVIAN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:VIVIAN
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6090 CULPEPPER RD SW
Mailing Address - Street 2:
Mailing Address - City:OCEAN ISLE BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28469-6000
Mailing Address - Country:US
Mailing Address - Phone:910-537-6445
Mailing Address - Fax:
Practice Address - Street 1:6090 CULPEPPER RD SW
Practice Address - Street 2:
Practice Address - City:OCEAN ISLE BEACH
Practice Address - State:NC
Practice Address - Zip Code:28469-6000
Practice Address - Country:US
Practice Address - Phone:910-537-6445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-26
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW0000007135104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No104100000XBehavioral Health & Social Service ProvidersSocial Worker