Shannon Dale Bailey, M.A., LCADC, CCS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

168771 Issued in KY

Practice address

105 Eastside Dr
Georgetown, KY 40324-9797

Phone

(502) 866-0664

Fax

(502) 866-0666

NPI assigned

Dec 8, 2011

Last updated

Jul 21, 2023By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chrysalis House, Inc.

  • Substance Abuse Rehabilitation Facility
  • Lexington, KY
  • NPI 1962627273
  NPD (past)

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

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1073881744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 EASTSIDE DR",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249797",
            "telephone_number": "502-866-0664",
            "fax_number": "502-866-0666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 EASTSIDE DR",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249797",
            "telephone_number": "502-866-0664",
            "fax_number": "502-866-0666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "SHANNON",
        "middle_name": "DALE",
        "credential": "M.A., LCADC, CCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-08",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "168771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80236",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCADC",
            "identifier": "168771",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Johnathan David Arthur, LBA
• Sarah Atkins, LMT
• Sarah E. Ayers, DC
• Back 2 Life Chiropractic, PSC
• Baili Rose Bailey, PA-C
• Ajwa Bajwa
• Barbara S. Baker, ARNP
• Daniel Ryan Baker
• John Max Baker, DC
• Kimberly Dione Baker, M.ED., CCC-SLP

• Addiction (Substance Use Disorder) Counselor in Georgetown, KY
• Providers in Georgetown, KY by specialty
• Addiction (Substance Use Disorder) Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.