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NPI Code Detail

MEDICARE: MS. IRIS LYNN BAILEY LPCC-S

MEDICARE: MS. IRIS LYNN BAILEY LPCC-S
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorE-0500778OH
2101YP1600XPastoral CounselorE0500778OH
3101YP2500XProfessional CounselorE0500778OH
4101YM0800XMental Health CounselorE-0500778OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073841847
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. IRIS LYNN BAILEY LPCC-S
Provider Business Mailing Address
First Line : 4517 RENAISSANCE PKWY
Second Line :
City : WARRENSVILLE HEIGHTS
State : OH
Zip : 44128-5701
Country : US
Telephone Number : 216-360-9343
Fax Number : 216-360-9345
Provider Business Practice Location Address
First Line : 4517 RENAISSANCE PKWY
Second Line :
City : WARRENSVILLE HEIGHTS
State : OH
Zip : 44128-5701
Country : US
Telephone Number : 216-360-9343
Fax Number : 216-360-9345
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2009
Last Update Date : 04/12/2022

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