Provider Demographics
NPI:1831957109
Name:BAILEY GAMMILL LPC, LLC
Entity type:Organization
Organization Name:BAILEY GAMMILL LPC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:AMON
Authorized Official - Middle Name:
Authorized Official - Last Name:GAMMILL
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, NCC
Authorized Official - Phone:256-274-4462
Mailing Address - Street 1:1505 CURTIS DR SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-6654
Mailing Address - Country:US
Mailing Address - Phone:256-274-4462
Mailing Address - Fax:
Practice Address - Street 1:1505 CURTIS DR SE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-6654
Practice Address - Country:US
Practice Address - Phone:256-274-4462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty