Carl Eugene Bailey Jr., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS 19539 Issued in CA

Practice address

233 Base Line Rd
Box 400
La Verne, CA 91750-2353

Phone

(909) 593-2581

NPI assigned

Mar 21, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Haynes Family of Programs

  • Mental Illness Community Based Residential Treatment Facility
  • La Verne, CA
  • NPI 1164548236
  NPD (past)
• Haynes Family of Programs

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • La Verne, CA
  • NPI 1669905832
  NPD (past)
• Leroy Haynes Center

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • La Verne, CA
  • NPI 1467713743
  NPD (past)

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699891788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 BASE LINE RD",
            "address_2": "BOX 400",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917502353",
            "telephone_number": "909-593-2581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 BASE LINE RD",
            "address_2": "BOX 400",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917502353",
            "telephone_number": "909-593-2581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "CARL",
        "middle_name": "EUGENE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 19539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OUTPATIENT MENTAL HEALTH",
            "identifier": "7565A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hyyawatha Autrey, LVN
• Maurice L Autrey
• Amanda Avalos
• Azam Aleemuddin DDS, Inc.
• B.M.E Medical Group
• Dcorey Baines
• Camilo P Balacuit III III, AMFT
• Eileen Patricia Banda, LVN
• Mark H Barak, MD
• Julio Barcelo Jr.

• All providers in La Verne, CA
• Clinical Social Worker in California

• 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.