Individual provider Active NPI

Angelique Bailey, LMFT

  • Marriage & Family Therapist
  • Carmichael, CA
National Provider Identifier
1417735010
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
140767 Issued in CA
Practice address
8037 Fair Oaks Blvd
Carmichael, CA 95608-6742
Phone
(404) 988-0512
NPI assigned
Sep 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 140767 CA Primary

Addresses

Primary practice location

8037 Fair Oaks Blvd
Carmichael, CA 95608-6742

Mailing address

PO Box 580786
Elk Grove, CA 95758-0014
Phone (404) 988-0512

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
140767CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Uprooted Marriage and Family Therapy CurrentSince Sep 24, 2023 Accepting new patients

Locations

8037 Fair Oaks Blvd
Carmichael, CA 95608
Phone (404) 988-0512

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": "1694736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1417735010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 580786",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957580014",
            "telephone_number": "404-988-0512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8037 FAIR OAKS BLVD",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956086742",
            "telephone_number": "404-988-0512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "ANGELIQUE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-15",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "140767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmichael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.