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General NPI Number Information
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NPI Number | 1740963909
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Entity Type | Individual
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Provider Name | BRIAN R BAILEY MA, LPC, NCC
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Gender | Male
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Dates
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Enumeration Date | 08/14/2023
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 110 YE OLDE KINGS HWY
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City | NORTH MYRTLE BEACH
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State | SC
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Zip | 29582-4384
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Country | US
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Telephone | 843-663-0770
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Fax | 843-663-0772
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Provider Business Mailing Address
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Address Line | 9895 MERRY LN
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City | MURRELLS INLET
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State | SC
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Zip | 29576-7504
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Country | US
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Telephone | 843-267-4087
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 10720
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License Number State | SC
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