Healthcare Provider Details

I. General information

NPI: 1801289327
Provider Name (Legal Business Name): KARLA BAILEY PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KARLA BAILEY COOPER PSY.D.

II. Dates (important events)

Enumeration Date: 03/09/2015
Last Update Date: 01/06/2021
Certification Date: 01/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5155 W WOODMILL DR SUITE 17
WILMINGTON DE
19808-4067
US

IV. Provider business mailing address

4867 PLUM RUN CT
WILMINGTON DE
19808-1715
US

V. Phone/Fax

Practice location:
  • Phone: 301-275-0225
  • Fax: 855-477-4383
Mailing address:
  • Phone: 301-275-0225
  • Fax: 855-477-4383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberB1-0000964
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberB1-0000964
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: