Provider Demographics
NPI:1194979898
Name:BAILEY, PAULA L (LMFT)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:L
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 262513
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33685-2513
Mailing Address - Country:US
Mailing Address - Phone:813-948-6000
Mailing Address - Fax:
Practice Address - Street 1:1532 US HIGHWAY 41
Practice Address - Street 2:SUITE H
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-2936
Practice Address - Country:US
Practice Address - Phone:813-948-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT 1739106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist