Active NPI
Kemar Bailey, BA
- Mental Health Counselor
- Waterbury, CT
National Provider Identifier
1013283399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 141 E Main St
Waterbury, CT 06702-2310 - Phone
- (203) 575-0466
- Fax
- (203) 575-1817
- NPI assigned
- Mar 30, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
141 E Main St
Waterbury, CT 06702-2310
Mailing address
141 E Main St
Waterbury, CT 06702-2310
Phone (203) 575-0466
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101Y00000X | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| KRB, LLC | Mental Health | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333065600000",
"number": "1013283399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 E MAIN ST",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067022310",
"telephone_number": "203-575-0466",
"fax_number": "203-575-1817"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "141 E MAIN ST",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067022310",
"telephone_number": "203-575-0466",
"fax_number": "203-575-1817"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAILEY",
"first_name": "KEMAR",
"credential": "BA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-03-30",
"last_updated": "2012-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101Y00000X",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waterbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.