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NPI Code Detail

MEDICARE: BAILEE YORK

MEDICARE: BAILEE YORK
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) Counselor02621-INV

General Provider Information

NPI Number : 1508613555
Entity Type Code : Individual
Provider Name (Legal Business Name) : BAILEE YORK
Provider Business Mailing Address
First Line : 4320 FENTON LN
Second Line :
City : N LAS VEGAS
State : NV
Zip : 89032-0143
Country : US
Telephone Number : 702-588-3747
Fax Number :
Provider Business Practice Location Address
First Line : 2121 W CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-2205
Country : US
Telephone Number : 702-382-7746
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2024
Last Update Date : 05/06/2024

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Directions to “ BAILEE YORK ” Practice Location

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