Provider Demographics
NPI:1306285895
Name:BAILEY, CAROLE S (LCPC-C)
Entity type:Individual
Prefix:
First Name:CAROLE
Middle Name:S
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LCPC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 PARK ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-5093
Mailing Address - Country:US
Mailing Address - Phone:207-992-0410
Mailing Address - Fax:207-992-0414
Practice Address - Street 1:157 PARK ST
Practice Address - Street 2:SUITE 5
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-5093
Practice Address - Country:US
Practice Address - Phone:207-992-0410
Practice Address - Fax:207-992-0414
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL4088101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor