Provider Demographics
NPI:1275347700
Name:BAILEY, JASON TODD (BCBA, LBA)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:TODD
Last Name:BAILEY
Suffix:
Gender:M
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 WEEPING WILLOW DR APT D
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-3982
Mailing Address - Country:US
Mailing Address - Phone:434-333-5301
Mailing Address - Fax:
Practice Address - Street 1:66 TIMBEROAK CT
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-3459
Practice Address - Country:US
Practice Address - Phone:434-515-0877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
VA0133003942103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst