Healthcare Provider Details

I. General information

NPI: 1669802823
Provider Name (Legal Business Name): PAUL BAILEY III LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2013
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 DAWSON RD
FORREST CITY AR
72335-2088
US

IV. Provider business mailing address

603 FORD RD
MARION AR
72364-8035
US

V. Phone/Fax

Practice location:
  • Phone: 870-630-2328
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberP1608101
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: