Provider Demographics
NPI:1396500195
Name:BAILEY, JESSICA KAREN (LMSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:KAREN
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 WEST ST
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:NY
Mailing Address - Zip Code:13619-9703
Mailing Address - Country:US
Mailing Address - Phone:315-346-3306
Mailing Address - Fax:315-346-6005
Practice Address - Street 1:9508 ARTZ ROAD
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:NY
Practice Address - Zip Code:13305
Practice Address - Country:US
Practice Address - Phone:315-346-3306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker