Kimberly Gray Bailey, M.A. LMFT
Individual provider Active NPI Marriage & Family Therapist · Glendale, AZ
NPI 1467549428 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1467549428
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 10200 (AZ)
- Practice address
- 18001 N 79TH Ave
Suite B-45
Glendale, AZ 85308-8388 - Phone
- (623) 570-3634
- Fax
- (623) 334-6724
- NPI assigned
- Oct 9, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240311001755 | AZ | Practitioner - Marriage and Family Therapist | 7416393616 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 10200 | AZ | Yes |
Addresses
Primary practice location
18001 N 79TH Ave
Suite B-45
Glendale, AZ 85308-8388
Mailing address
18001 N 79TH Ave
Suite B-45
Glendale, AZ 85308-8388
Phone (623) 570-3634
Other providers in Glendale, AZ
- Douglas George Bailes
- Candace Kay Bailey
- Craig Bailey
- Emily Brooke Bailey
- Jaime Bailey
- Molly Ann Bailey
- Patrick Byron Bailey
- Victoria Bain
- Harjot Kaur Bains
- Brian Chester Baird
All providers in Glendale, AZ · Marriage & Family Therapist in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.