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NPI Code Detail

MEDICARE: CAROLINE J BAILEY LCSW

MEDICARE: CAROLINE J BAILEY LCSW
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 CounselorIA

General Provider Information

NPI Number : 1699811091
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLINE J BAILEY LCSW
Provider Business Mailing Address
First Line : 1845 GRANDSTAND PL
Second Line :
City : ELGIN
State : IL
Zip : 60123-6603
Country : US
Telephone Number : 847-695-0484
Fax Number :
Provider Business Practice Location Address
First Line : 1845 GRANDSTAND PL
Second Line :
City : ELGIN
State : IL
Zip : 60123-6603
Country : US
Telephone Number : 847-695-0484
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2007
Last Update Date : 07/08/2007

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Directions to “ CAROLINE J BAILEY LCSW” Practice Location

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