Active NPI
Brent Stephen Bailey, CRC, LSW
- Rehabilitation Counselor
- Bangor, ME
National Provider Identifier
1124315478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Counselor
- License
- 00107933
- Practice address
- 166 Broadway
Bangor, ME 04401-5208 - Phone
- (207) 947-9630
- Fax
- (207) 947-9633
- NPI assigned
- Jul 7, 2011
- 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 |
|---|---|---|---|---|
| Rehabilitation Counselor | 225C00000X | 00107933 | Primary |
Addresses
Primary practice location
166 Broadway
Bangor, ME 04401-5208
Mailing address
166 Broadway
Bangor, ME 04401-5208
Phone (207) 947-9630
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309996800000",
"number": "1124315478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "166 BROADWAY",
"city": "BANGOR",
"state": "ME",
"postal_code": "044015208",
"telephone_number": "207-947-9630",
"fax_number": "207-947-9633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "166 BROADWAY",
"city": "BANGOR",
"state": "ME",
"postal_code": "044015208",
"telephone_number": "207-947-9630",
"fax_number": "207-947-9633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAILEY",
"first_name": "BRENT",
"middle_name": "STEPHEN",
"name_prefix": "Mr.",
"credential": "CRC, LSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-07",
"last_updated": "2011-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "225C00000X",
"taxonomy_group": "",
"desc": "Rehabilitation Counselor",
"state": null,
"license": "00107933",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bangor, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.