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General NPI Number Information
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NPI Number | 1316322811
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Entity Type | Organization
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Legal Business Name | BAILEY AND ASSOCIATES, COUNSELING & PSYCHOTHERAPY
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Dates
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Enumeration Date | 07/25/2015
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Last Update Date | 07/25/2015
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Provider Practice Location Address
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Address Line | 2302 W NORTH AVE #1E
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City | CHICAGO
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State | IL
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Zip | 60647-6260
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Country | US
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Telephone | 312-623-3260
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Fax |
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Provider Business Mailing Address
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Address Line | 2124 W POTOMAC AVE UNIT 2
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City | CHICAGO
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State | IL
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Zip | 60622-3010
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PSYCHOTHERAPIST
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Name | NICOLE M BAILEY
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Credential | LCPC
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Telephone | 312-623-3260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 180007162
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License Number State | IL
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