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General NPI Number Information
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NPI Number | 1942166038
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Entity Type | Individual
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Provider Name | MARIO BAILEY
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Gender | Male
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Dates
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Enumeration Date | 01/01/2026
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Last Update Date | 01/01/2026
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Provider Practice Location Address
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Address Line | 3100 BROADWAY BLVD STE 400
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City | KANSAS CITY
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State | MO
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Zip | 64111-2591
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Country | US
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Telephone | 816-931-4527
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Fax |
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Provider Business Mailing Address
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Address Line | 13106 E 57TH ST
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City | KANSAS CITY
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State | MO
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Zip | 64133-3615
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Country | US
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Telephone | 815-342-6007
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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 | 2023023749
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License Number State | MO
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