Healthcare Provider Details

I. General information

NPI: 1841973591
Provider Name (Legal Business Name): A BAILEY COUNSELING SERVICES, LICENSED CLINICAL SOCIAL WORK PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2023
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4790 MIDDLE SETTLEMENT RD
WHITESBORO NY
13492-2834
US

IV. Provider business mailing address

4790 MIDDLE SETTLEMENT RD
WHITESBORO NY
13492-2834
US

V. Phone/Fax

Practice location:
  • Phone: 315-601-8437
  • Fax: 315-922-7645
Mailing address:
  • Phone: 315-601-8437
  • Fax: 315-922-7645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: AMANDA K BAILEY
Title or Position: OWNER/OPERATOR
Credential: LCSW-R
Phone: 315-601-8437