MEDICARE: MS. EMILY ELIZABETH BAILEY LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	6385	LA

General Provider Information

NPI Number	:	1255464566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. EMILY ELIZABETH BAILEY LPC

Provider Business Mailing Address
First Line	:	342 BURROW LN
Second Line	:
City	:	COTTON VALLEY
State	:	LA
Zip	:	71018-2932
Country	:	US
Telephone Number	:	183-510-4784
Fax Number	:

Provider Business Practice Location Address
First Line	:	7505 PINES RD STE 1115
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71129-3900
Country	:	US
Telephone Number	:	318-683-4086
Fax Number	:	318-623-4087

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	12/21/2020

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