Individual provider Active NPI

Mary Margaret Bailes, LCPC

  • Professional Counselor
  • Baltimore, MD
National Provider Identifier
1255660742
Registry record updated Dec 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC1338 Issued in MD
Practice address
5510 Nathan Shock Dr
Baltimore, MD 21224-6823
Phone
(410) 550-1600
Fax
(410) 550-3826
NPI assigned
Dec 14, 2009
Last updated
Dec 14, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LC1338 MD Primary

Addresses

Primary practice location

5510 Nathan Shock Dr
Baltimore, MD 21224-6823

Mailing address

917 Country Club Rd
Havre de Grace, MD 21078-2106
Phone (410) 273-9350

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

LicenseStateTypeSpecialty
LC1338MDMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1260748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260748800000",
    "number": "1255660742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 COUNTRY CLUB RD",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210782106",
            "telephone_number": "410-273-9350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5510 NATHAN SHOCK DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212246823",
            "telephone_number": "410-550-1600",
            "fax_number": "410-550-3826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILES",
        "first_name": "MARY",
        "middle_name": "MARGARET",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-14",
        "last_updated": "2009-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC1338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2009; 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.