Lydia Bailey, LCSW

Individual provider Active NPI Clinical Social Worker · Corsicana, TX

NPI 1679088561 · NPPES record last updated Mar 17, 2018

Key facts

NPI
1679088561
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
57964 (TX)
Practice address
120 E 2ND Ave
Corsicana, TX 75110-3115
Phone
(903) 872-3772
NPI assigned
Dec 13, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
57964TXMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 57964 TX Yes

Addresses

Primary practice location

120 E 2ND Ave
Corsicana, TX 75110-3115

Mailing address

400 N Fulton St
Rice, TX 75155-2503
Phone (903) 654-2487

Other practice location 1

400 N Fulton St
Rice, TX 75155-2503
Phone (903) 654-2487

Other providers in Corsicana, TX

All providers in Corsicana, TX · Clinical Social Worker in Texas

Sources for this page

Verify at the official NPI Registry.