Healthcare Provider Details

I. General information

NPI: 1316504806
Provider Name (Legal Business Name): BAILEY SESSIONS MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2019
Last Update Date: 05/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5807 LONG PARK RD
CUMMING GA
30040-5718
US

IV. Provider business mailing address

1101 JUNIPER ST NE APT 1004
ATLANTA GA
30309-7663
US

V. Phone/Fax

Practice location:
  • Phone: 404-649-0599
  • Fax:
Mailing address:
  • Phone: 770-490-0350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: