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General NPI Number Information
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NPI Number | 1255871703
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Entity Type | Organization
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Legal Business Name | KELLEY BAILEY, LLC
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Dates
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Enumeration Date | 03/02/2017
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 320 N BROADWAY STE 112
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City | EDMOND
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State | OK
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Zip | 73034-3642
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Country | US
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Telephone | 405-474-1813
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Fax |
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Provider Business Mailing Address
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Address Line | 3325 FRENCH PARK DR SUITE 9
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City | EDMOND
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State | OK
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Zip | 73034-7277
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Country | US
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Telephone | 405-474-1813
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | KELLEY R BAILEY
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Credential |
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Telephone | 405-474-1813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6232
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6232
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 6232
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License Number State | OK
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Taxonomy #4
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6232
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License Number State | OK
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