Provider Demographics
NPI:1073326344
Name:BAILEY, VANESSA (CLC DOULA)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:CLC DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2549 YATES AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-5310
Mailing Address - Country:US
Mailing Address - Phone:646-706-2905
Mailing Address - Fax:
Practice Address - Street 1:2549 YATES AVE # 1
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-5310
Practice Address - Country:US
Practice Address - Phone:646-706-2905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X
NY174H00000X, 174N00000X, 374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No171400000XOther Service ProvidersHealth & Wellness Coach
No174H00000XOther Service ProvidersHealth Educator
No174N00000XOther Service ProvidersLactation Consultant, Non-RN