Stephanie Jane Bailey, LCSW

Individual provider Active NPI Clinical Social Worker · Flowery Branch, GA

NPI 1366670895 · NPPES record last updated Apr 29, 2010

Key facts

NPI
1366670895
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
CSW003963 (GA)
Practice address
4331 Thurmon Tanner Rd
Flowery Branch, GA 30542-2829
Phone
(678) 513-5700
NPI assigned
Jun 23, 2009
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW003963 GA Yes

Addresses

Primary practice location

4331 Thurmon Tanner Rd
Flowery Branch, GA 30542-2829

Mailing address

4331 Thurmon Tanner Rd
Flowery Branch, GA 30542-2829
Phone (678) 513-5700

Other identifiers

IdentifierTypeStateIssuer
202I808572OtherGAMEDICARE PTAN

Other providers in Flowery Branch, GA

All providers in Flowery Branch, GA · Clinical Social Worker in Georgia

Sources for this page

Verify at the official NPI Registry.