MEDICARE: MARISSA 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
1	101YP2500X	Professional Counselor	PC019721	PA

General Provider Information

NPI Number	:	1174008825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISSA BAILEY LPC

Provider Business Mailing Address
First Line	:	1902 CHERRY ST UNIT C
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16502-2648
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1902 CHERRY ST UNIT C
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16502-2648
Country	:	US
Telephone Number	:	814-480-0980
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2018
Last Update Date	:	03/04/2026

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Directions to “ MARISSA BAILEY LPC” Practice Location

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