Provider Demographics
NPI:1154968311
Name:BAILEY, SIMONE ALLISON (BA, QMHA)
Entity type:Individual
Prefix:MRS
First Name:SIMONE
Middle Name:ALLISON
Last Name:BAILEY
Suffix:
Gender:F
Credentials:BA, QMHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5060 W HACIENDA AVE APT 2004
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-0340
Mailing Address - Country:US
Mailing Address - Phone:484-424-2303
Mailing Address - Fax:
Practice Address - Street 1:5060 W HACIENDA AVE APT 2004
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-0340
Practice Address - Country:US
Practice Address - Phone:484-424-2303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-06
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor