Provider Demographics
NPI:1316753585
Name:BAILEY, KACY JEAN (MSW)
Entity type:Individual
Prefix:MRS
First Name:KACY
Middle Name:JEAN
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14445 N COUNTY ROAD 450 E
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47320-9596
Mailing Address - Country:US
Mailing Address - Phone:765-748-1752
Mailing Address - Fax:
Practice Address - Street 1:14445 N COUNTY ROAD 450 E
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47320-9596
Practice Address - Country:US
Practice Address - Phone:765-748-1752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-03
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst