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NPI Code Detail

MEDICARE: KIMBERLY M BAILEY CCS

MEDICARE: KIMBERLY M BAILEY CCS
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) Counselor
2101YM0800XMental Health Counselor2622NC

General Provider Information

NPI Number : 1437338308
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY M BAILEY CCS
Provider Business Mailing Address
First Line : 966 MYRTLE DR
Second Line :
City : ROCK HILL
State : SC
Zip : 29730-3658
Country : US
Telephone Number : 704-606-4255
Fax Number : 704-332-0124
Provider Business Practice Location Address
First Line : 145 REMOUNT RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28203-5013
Country : US
Telephone Number : 704-332-9001
Fax Number : 704-332-0124
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/29/2007
Last Update Date : 11/16/2023

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Directions to “ KIMBERLY M BAILEY CCS” Practice Location

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