Provider Demographics
NPI:1396363511
Name:COLE, BAILEY (PHD)
Entity type:Individual
Prefix:DR
First Name:BAILEY
Middle Name:
Last Name:COLE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 TURMERIC LN
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-3134
Mailing Address - Country:US
Mailing Address - Phone:510-367-8398
Mailing Address - Fax:
Practice Address - Street 1:6208 FAYETTEVILLE RD STE 106
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6286
Practice Address - Country:US
Practice Address - Phone:919-234-7706
Practice Address - Fax:919-220-0413
Is Sole Proprietor?:No
Enumeration Date:2020-07-14
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5736103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical