Active NPI
Paul Alexander Baillif, LPC
- Mental Health Counselor
- Mooresville, NC
National Provider Identifier
1124197850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 4401
- Practice address
- 484 Williamson Rd
Suite E-105
Mooresville, NC 28117-8191 - Phone
- (704) 662-7977
- Fax
- (704) 662-9204
- NPI assigned
- Nov 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | 4401 | NC | Primary |
Addresses
Primary practice location
484 Williamson Rd
Suite E-105
Mooresville, NC 28117-8191
Mailing address
PO Box 5260
Mooresville, NC 28117-5260
Phone (704) 662-7977
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4401 | NC | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124197850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5260",
"city": "MOORESVILLE",
"state": "NC",
"postal_code": "281175260",
"telephone_number": "704-662-7977",
"fax_number": "704-662-9204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "484 WILLIAMSON RD",
"address_2": "SUITE E-105",
"city": "MOORESVILLE",
"state": "NC",
"postal_code": "281178191",
"telephone_number": "704-662-7977",
"fax_number": "704-662-9204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAILLIF",
"first_name": "PAUL",
"middle_name": "ALEXANDER",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "4401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mooresville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.