Healthcare Provider Details

I. General information

NPI: 1720031016
Provider Name (Legal Business Name): GARY BERNARD BAILEY MA, MSW, PH.D., LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ALAMANCE EAP, LLC LIFE WORKS

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 03/17/2022
Certification Date: 03/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

291 N GRAHAM HOPEDALE RD
BURLINGTON NC
27217-2971
US

IV. Provider business mailing address

291 N GRAHAM HOPEDALE RD
BURLINGTON NC
27217-2971
US

V. Phone/Fax

Practice location:
  • Phone: 336-228-0793
  • Fax: 877-227-0793
Mailing address:
  • Phone: 336-228-0793
  • Fax: 877-227-0793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number129
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904 002803
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number38595
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC000300
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: