Frederick Lawson Bailey, CCADC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Atlanta, GA
NPI 1932389350 · NPPES record last updated Nov 14, 2007
Key facts
- NPI
- 1932389350
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- C0036 (GA)
- Practice address
- 265 Boulevard NE
Atlanta, GA 30312-1208 - Phone
- (404) 730-1650
- Fax
- (404) 730-1651
- NPI assigned
- Nov 14, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C0036 | GA | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | C0036 | GA | Yes |
Addresses
Primary practice location
265 Boulevard NE
Atlanta, GA 30312-1208
Mailing address
265 Boulevard NE
Atlanta, GA 30312-1208
Phone (404) 730-1650
Other providers in Atlanta, GA
- Christopher Lee Bailey
- Diane Bailey
- Dianne Elisabeth Bailey
- Erroll J Bailey
- Evan Bailey
- Geraldine Bailey
- James Bailey
- James Lynch Bailey
- Jason PD Bailey
- Jillian Bailey
All providers in Atlanta, GA · Addiction (Substance Use Disorder) Counselor in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.