Provider Demographics
NPI:1285899930
Name:BAILEY, MARY SHEREE (PHD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:SHEREE
Last Name:BAILEY
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1855 CRANE RIDGE DR SUITE C
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-7730
Mailing Address - Country:US
Mailing Address - Phone:769-218-8298
Mailing Address - Fax:
Practice Address - Street 1:1855 CRANE RIDGE DR STE C
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4944
Practice Address - Country:US
Practice Address - Phone:769-218-8298
Practice Address - Fax:769-207-7269
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-22
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS641193103TC0700X
MS1824101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty