Provider Demographics
NPI:1982986725
Name:PAYNE, BAILEY ANNE (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:ANNE
Last Name:PAYNE
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:BAILEY
Other - Middle Name:ANNE
Other - Last Name:BISHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1321 MURFREESBORO PIKE STE 702
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-2679
Mailing Address - Country:US
Mailing Address - Phone:844-359-7629
Mailing Address - Fax:615-815-1946
Practice Address - Street 1:1711 DESTINY LN STE 106
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-1067
Practice Address - Country:US
Practice Address - Phone:270-702-4641
Practice Address - Fax:615-815-1946
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1-14-10256103K00000X
103K00000X, 171M00000X
KY167417103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No171M00000XOther Service ProvidersCase Manager/Care Coordinator