Lisa D Bailey, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PY9441 Issued in FL

Practice address

12412 San Jose Blvd Ste 203
Jacksonville, FL 32223-8620

Phone

(904) 432-3321

Fax

(904) 432-3324

NPI assigned

Mar 4, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Nautilus Behavioral Health, PLLC

  • Clinical Child & Adolescent Psychologist
  • Jacksonville, FL
  • NPI 1134577901
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1267660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1053634014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12412 SAN JOSE BLVD STE 203",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238620",
            "telephone_number": "904-432-3321",
            "fax_number": "904-432-3324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12412 SAN JOSE BLVD STE 203",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238620",
            "telephone_number": "904-432-3321",
            "fax_number": "904-432-3324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "LISA",
        "middle_name": "D",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-04",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "PY9441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Bailey, RDN
• Holly Bailey
• James Kevin Bailey, M.S.
• Jessica Bailey, LCSW
• Julia A. Bailey, CRNA
• Michelle Y Bailey
• Patrick Bailey, CRNA
• Shanika Octavia Bailey
• Toya Bailey
• Zafria Bailey

• Clinical Child & Adolescent Psychologist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Child & Adolescent Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.