Healthcare Provider Details

I. General information

NPI: 1265702872
Provider Name (Legal Business Name): LAUREN BAILEY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2012
Last Update Date: 02/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 MULL AVE
AKRON OH
44313-7502
US

IV. Provider business mailing address

2591 WAYLAND RD
DEERFIELD OH
44411-8751
US

V. Phone/Fax

Practice location:
  • Phone: 800-621-5207
  • Fax:
Mailing address:
  • Phone: 724-683-5112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC005740
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.0600470
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: