Provider Demographics
NPI:1104314632
Name:BAILEY, JAMES WOODROW (PHD, LCSWS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WOODROW
Last Name:BAILEY
Suffix:
Gender:M
Credentials:PHD, LCSWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2706 LAKE VILLA DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-7650
Mailing Address - Country:US
Mailing Address - Phone:346-341-7971
Mailing Address - Fax:
Practice Address - Street 1:2706 LAKE VILLA DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-7650
Practice Address - Country:US
Practice Address - Phone:281-782-1641
Practice Address - Fax:281-969-7259
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-30
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX601181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX60118OtherTEXAS STATE BOARD OF LICENSED SOCIAL WORKER EXAMINERS