Bailey'S Innovation Group

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BAILEY'S INNOVATION GROUP

Practice address

4030 Wake Forest Rd Ste 300
Raleigh, NC 27609-6800

Phone

(919) 438-4060

NPI assigned

Dec 6, 2018

Organization subpart

No

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

Authorized official

Name

Sherisse Bailey, LPCS,LCASNPI 1083943054

Title

Owner

Phone

(919) 438-4060

Specialties & licenses 4

Addresses

Other names 1

• Mind Over Matters Counseling Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sherisse Kelly Bailey, LCMHCS,LCASMCCS

  • Mental Health Counselor
  • Raleigh, NC
  • NPI 1083943054

  Addiction (Substance Use Disorder), NC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1544054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544054400000",
    "number": "1609347368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4030 WAKE FOREST RD STE 300",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096800",
            "telephone_number": "919-438-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4030 WAKE FOREST RD STE 300",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096800",
            "telephone_number": "919-438-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAILEY'S INNOVATION GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-06",
        "last_updated": "2018-12-06",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "SHERISSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-438-4060",
        "authorized_official_credential": "LPCS,LCAS"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mind Over Matters Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sheree Lynn Bailey, RN
• Sherisse Kelly Bailey, LCMHCS,LCASMCCS
• Shibahn Jolene Bailey, CRNA, MS
• Talia Bailey, BSW
• Trixy Baldwin Bailey, NCC, LPC, LCAS
• Bailliard Henry Pediatric Cardiology
• Frederique C Bailliard, MD
• Bain Dermatology, P.a.
• Clara Downing Bain, LCAS
• David Alfred Bain Jr., MA, CSAC, LCAS

• Community/Behavioral Health Agency in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.