Provider Demographics
NPI:1841973591
Name:A BAILEY COUNSELING SERVICES, LICENSED CLINICAL SOCIAL WORK PLLC
Entity type:Organization
Organization Name:A BAILEY COUNSELING SERVICES, LICENSED CLINICAL SOCIAL WORK PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:315-601-8437
Mailing Address - Street 1:4790 MIDDLE SETTLEMENT RD
Mailing Address - Street 2:
Mailing Address - City:WHITESBORO
Mailing Address - State:NY
Mailing Address - Zip Code:13492-2834
Mailing Address - Country:US
Mailing Address - Phone:315-601-8437
Mailing Address - Fax:315-922-7645
Practice Address - Street 1:320 HERKIMER RD
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-2348
Practice Address - Country:US
Practice Address - Phone:315-601-8437
Practice Address - Fax:315-922-7645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty