Provider Demographics
NPI:1326187964
Name:BAILER, VICTORIA B (LCSW)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:B
Last Name:BAILER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 PICCARD DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4320
Mailing Address - Country:US
Mailing Address - Phone:240-777-4000
Mailing Address - Fax:240-777-4800
Practice Address - Street 1:1301 PICCARD DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4320
Practice Address - Country:US
Practice Address - Phone:240-777-4000
Practice Address - Fax:240-777-4800
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD104061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD816700100Medicaid