Healthcare Provider Details

I. General information

NPI: 1265044234
Provider Name (Legal Business Name): BRITT BAILEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2020
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4652 NEWINGTON RD
JEFFERSON MD
21755-8239
US

IV. Provider business mailing address

4652 NEWINGTON RD
JEFFERSON MD
21755-8239
US

V. Phone/Fax

Practice location:
  • Phone: 301-818-0745
  • Fax:
Mailing address:
  • Phone: 301-818-0745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number25977
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: