MEDICARE: KELLEY BAILEY, LLC

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	101YM0800X	Mental Health Counselor	6232	OK
2	101YP2500X	Professional Counselor	6232	OK
3	106H00000X	Marriage & Family Therapist	6232	OK
4	101Y00000X	Counselor	6232	OK

Other Identifiers

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

General Provider Information

NPI Number	:	1255871703
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KELLEY BAILEY, LLC

Provider Business Mailing Address
First Line	:	3325 FRENCH PARK DR
Second Line	:	SUITE 9
City	:	EDMOND
State	:	OK
Zip	:	73034-7277
Country	:	US
Telephone Number	:	405-474-1813
Fax Number	:

Provider Business Practice Location Address
First Line	:	320 N BROADWAY STE 112
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73034-3642
Country	:	US
Telephone Number	:	405-474-1813
Fax Number	:

Authorized Official
Title or Position	:	LICENSED PROFESSIONAL COUNSELOR
Name	:	KELLEY R BAILEY
Credential	:
Telephone Number	:	405-474-1813

Provider Enumeration Date	:	03/02/2017
Last Update Date	:	02/10/2025

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Directions to “KELLEY BAILEY, LLC ” Practice Location

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