Healthcare Provider Details

I. General information

NPI: 1578433231
Provider Name (Legal Business Name): GENEE MONTANA BAILEY APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MONTANA BAILEY

II. Dates (important events)

Enumeration Date: 11/07/2025
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3609 10TH AVE
LOS ANGELES CA
90018-4114
US

IV. Provider business mailing address

3609 10TH AVE
LOS ANGELES CA
90018-4114
US

V. Phone/Fax

Practice location:
  • Phone: 323-298-3680
  • Fax:
Mailing address:
  • Phone: 323-298-3680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPCCC21110
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT159446
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: