Provider Demographics
NPI:1538052204
Name:BAILEY, XAVIER
Entity type:Individual
Prefix:
First Name:XAVIER
Middle Name:
Last Name:BAILEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 CHELMSFORD ST STE 7
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-2335
Mailing Address - Country:US
Mailing Address - Phone:603-321-5175
Mailing Address - Fax:978-418-1081
Practice Address - Street 1:265 CHELMSFORD ST STE 7
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-2335
Practice Address - Country:US
Practice Address - Phone:603-321-5175
Practice Address - Fax:978-418-1081
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARBT-20-133884106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician