Individual provider Active NPI

Jamey Richard Bailey, LCSW

  • Clinical Social Worker
  • Champaign, IL
National Provider Identifier
1255963583
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149020958 Issued in IL
Practice address
701 Devonshire Drive, BLDG C
Suite 206, C-6
Champaign, IL 61820
Phone
(217) 722-2450
NPI assigned
Feb 5, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149020958 IL Primary

Addresses

Primary practice location

701 Devonshire Drive, BLDG C
Suite 206, C-6
Champaign, IL 61820

Mailing address

701 Devonshire Drive, BLDG C
Suite 206, C-6
Champaign, IL 61820
Phone (217) 722-2450

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
149020958ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Better Tomorrows- C a Winkler Counseling Services Clinical CurrentSince Feb 9, 2020 Accepting new patients

Locations

701 Devonshire Dr
Ste C6
Champaign, IL 61820
Phone (217) 722-2450

2009 Fox Dr
Ste W
Champaign, IL 61820

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1580860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1255963583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 DEVONSHIRE DRIVE, BLDG C",
            "address_2": "SUITE 206, C-6",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "61820",
            "telephone_number": "217-722-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 DEVONSHIRE DRIVE, BLDG C",
            "address_2": "SUITE 206, C-6",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "61820",
            "telephone_number": "217-722-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "JAMEY",
        "middle_name": "RICHARD",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-05",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149020958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; 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.