MEDICARE: JOHN WILLIAM BAILEY JR. MSW, LCSW

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	1041C0700X	Clinical Social Worker	C015079	NC

General Provider Information

NPI Number	:	1629642541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN WILLIAM BAILEY JR. MSW, LCSW

Provider Business Mailing Address
First Line	:	NMRTC OKINAWA
Second Line	:	PSC 482
City	:	FPO
State	:	AP
Zip	:	96362
Country	:	US
Telephone Number	:	544-630-1600
Fax Number	:

Provider Business Practice Location Address
First Line	:	KADENA AB BUILDING #626
Second Line	:	18TH MDG
City	:	APO
State	:	AP
Zip	:	96367
Country	:	US
Telephone Number	:	544-630-1600
Fax Number	:

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

Provider Enumeration Date	:	05/15/2021
Last Update Date	:	08/23/2024

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