MEDICARE: KEHELEY 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
1	1041C0700X	Clinical Social Worker	LCSW003044	GA

General Provider Information

NPI Number	:	1962756775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEHELEY BAILEY LCSW

Provider Business Mailing Address
First Line	:	3644 EDENBOURGH PL
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30066-3081
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	135 VILLAGE CTR W
Second Line	:
City	:	WOODSTOCK
State	:	GA
Zip	:	30188-5206
Country	:	US
Telephone Number	:	678-665-6587
Fax Number	:

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

Provider Enumeration Date	:	10/31/2012
Last Update Date	:	12/10/2025

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Directions to “ KEHELEY BAILEY LCSW” Practice Location

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