Jaclyn Poe Bailes, LPC-ASSOCIATE

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

90524 Issued in TX

Practice address

510 Austin Ave
Waco, TX 76701-2107

Phone

(903) 948-8038

NPI assigned

Dec 16, 2022

Last updated

Dec 16, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 9, 2025 through Jun 9, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1671148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671148800000",
    "number": "1326750761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 PRIVATE ROAD 1280",
            "city": "FAIRFIELD",
            "state": "TX",
            "postal_code": "758405188",
            "telephone_number": "903-948-8038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 AUSTIN AVE",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767012107",
            "telephone_number": "903-948-8038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILES",
        "first_name": "JACLYN",
        "middle_name": "POE",
        "credential": "LPC-ASSOCIATE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-16",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "90524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Backstrom, DO
• Shamji P Badhiwala, MD
• Chloe Baer Appleby
• John Bagnasco, M.D.
• Margaret E. Matyastik Baier, PH.D. LMFT
• Colin R Bailey, MD
• Courtney Bailey
• Holly Bailey
• Kira Ann Bailey, L.C.S.W.
• Pamela Bailey, M.S. L.P.C.

• Professional Counselor in Waco, TX
• Providers in Waco, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.