Healthcare Provider Details

I. General information

NPI: 1285422733
Provider Name (Legal Business Name): BAILEY CAMPBELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2025
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10524 EUCLID AVE # 1155A
CLEVELAND OH
44106-2205
US

IV. Provider business mailing address

2500 DERBYSHIRE RD APT 12
CLEVELAND HEIGHTS OH
44106-3231
US

V. Phone/Fax

Practice location:
  • Phone: 216-983-1362
  • Fax:
Mailing address:
  • Phone: 614-477-8089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.2406358
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: