Healthcare Provider Details

I. General information

NPI: 1053938266
Provider Name (Legal Business Name): BAILEY KENDRICK PARIS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTIN BAILEY KENDRICK

II. Dates (important events)

Enumeration Date: 07/03/2020
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4343 SHALLOWFORD RD STE 410
MARIETTA GA
30062-5067
US

IV. Provider business mailing address

142 KINGSLEY WAY SE
ACWORTH GA
30102-1170
US

V. Phone/Fax

Practice location:
  • Phone: 678-384-4911
  • Fax:
Mailing address:
  • Phone: 229-848-7738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW010282
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: