Healthcare Provider Details

I. General information

NPI: 1275446577
Provider Name (Legal Business Name): MS. ROBYN NELL BAILEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 N CORNERS PKWY
CUMMING GA
30040-2078
US

IV. Provider business mailing address

5338 ASHLEY DR SW
LILBURN GA
30047-6641
US

V. Phone/Fax

Practice location:
  • Phone: 678-341-3840
  • Fax:
Mailing address:
  • Phone: 404-476-9139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC017389
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: