Levi J Bailey

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Mapleton, UT

NPI 1124594676 · NPPES record last updated Oct 22, 2018

Key facts

NPI
1124594676
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
7658471-6005 (UT)
Practice address
853 S Crescent Row
Mapleton, UT 84664-5503
Phone
(385) 482-5189
Fax
(801) 465-7762
NPI assigned
Oct 22, 2018
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
7658471-6005UTMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 7658471-6005 UT Yes

Addresses

Primary practice location

853 S Crescent Row
Mapleton, UT 84664-5503

Mailing address

853 S Crescent Row
Mapleton, UT 84664-5503
Phone (385) 482-5189

Other providers in Mapleton, UT

All providers in Mapleton, UT · Addiction (Substance Use Disorder) Counselor in Utah

Sources for this page

Verify at the official NPI Registry.