Healthcare Provider Details

I. General information

NPI: 1427973403
Provider Name (Legal Business Name): CARALYN BAILEY
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: CARA BAILEY

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2821 BROOKSIDE CT
AUGUSTA KS
67010-2433
US

IV. Provider business mailing address

430 N WALNUT ST
AUGUSTA KS
67010-1036
US

V. Phone/Fax

Practice location:
  • Phone: 316-775-5491
  • Fax:
Mailing address:
  • Phone: 316-775-5491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number03880-T
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: