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NPI Code Detail

MEDICARE: JANE W BAILEY LPC

MEDICARE: JANE W BAILEY LPC
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
1101YM0800XMental Health Counselor3046NC

General Provider Information

NPI Number : 1134220999
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANE W BAILEY LPC
Provider Business Mailing Address
First Line : 8025 N POINT BLVD
Second Line : SUITE 231
City : WINSTON SALEM
State : NC
Zip : 27106-3262
Country : US
Telephone Number : 336-896-0065
Fax Number : 336-896-0710
Provider Business Practice Location Address
First Line : 8025 N POINT BLVD
Second Line : SUITE 231
City : WINSTON SALEM
State : NC
Zip : 27106-3262
Country : US
Telephone Number : 336-896-0065
Fax Number : 336-896-0710
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2006
Last Update Date : 07/08/2007

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