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General NPI Number Information
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NPI Number | 1932253895
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Entity Type | Organization
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Legal Business Name | BAILEY BEHAVIORAL HEALTH INC
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 12/06/2013
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Provider Practice Location Address
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Address Line | 80 12TH STREET SUITE 307 BOARD OF TRADE BUILDING
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City | WHEELING
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State | WV
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Zip | 26003
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Country | US
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Telephone | 304-242-6988
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Fax | 304-242-6951
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Provider Business Mailing Address
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Address Line | 80 12TH STREET SUITE 307 BOARD OF TRADE BUILDING
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City | WHEELING
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State | WV
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Zip | 26003
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Country | US
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Telephone | 304-242-6988
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Fax | 304-242-6951
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Authorized Official
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Title or Position | PRESIDENT PSYCHOLOGIST
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Name | PATRICIA M BAILEY
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Credential | PHD LPC
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Telephone | 304-242-6988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 802
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License Number State | WV
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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 | 1508
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License Number State | WV
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