Healthcare Provider Details

I. General information

NPI: 1528541968
Provider Name (Legal Business Name): AMY BAILEY-SHEETS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2018
Last Update Date: 09/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 CAMPUS RIDGE DR
MIDLAND MI
48640-6123
US

IV. Provider business mailing address

4000 WELLNESS DR
MIDLAND MI
48670-2000
US

V. Phone/Fax

Practice location:
  • Phone: 989-839-6188
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801081375
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: