Healthcare Provider Details

I. General information

NPI: 1558276436
Provider Name (Legal Business Name): BAILEY MICHELLE COWDEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12332 CRYSTAL CREEK CT
JACKSONVILLE FL
32258-1200
US

IV. Provider business mailing address

12332 CRYSTAL CREEK CT
JACKSONVILLE FL
32258-1200
US

V. Phone/Fax

Practice location:
  • Phone: 904-339-1532
  • Fax:
Mailing address:
  • Phone:
  • Fax: 904-339-1532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW26939
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: