Individual provider Active NPI

Gale Elaine Bailis, LPC

  • Mental Health Counselor
  • Canton, OH
National Provider Identifier
1386869402
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C5874 Issued in OH
Practice address
4801 Dressler Rd NW
Suite130
Canton, OH 44718-3667
Phone
(330) 649-7373
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C5874 OH Primary

Addresses

Primary practice location

4801 Dressler Rd NW
Suite130
Canton, OH 44718-3667

Mailing address

610 Leecrest St NW
Massillon, OH 44646-2032
Phone (330) 832-9619

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
C5874OHMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386869402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 LEECREST ST NW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446462032",
            "telephone_number": "330-832-9619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 DRESSLER RD NW",
            "address_2": "SUITE130",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183667",
            "telephone_number": "330-649-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILIS",
        "first_name": "GALE",
        "middle_name": "ELAINE",
        "name_prefix": "Miss",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C5874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.