=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811820483
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MAX BAILEY
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/04/2026
-----------------------------------------------------
Last Update Date | 06/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 231 CLARKSVILLE RD
-----------------------------------------------------
City | PRINCETON JUNCTION
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08550-5300
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-359-2266
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2209 GOLDFINCH BLVD # 2209
-----------------------------------------------------
City | PRINCETON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08540-6837
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 44SL07464900
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------