Provider Demographics
NPI:1992316301
Name:BAILEY, CLAUDETTE ELAIN
Entity type:Individual
Prefix:
First Name:CLAUDETTE
Middle Name:ELAIN
Last Name:BAILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1175 NE 125TH ST STE 420
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-5011
Mailing Address - Country:US
Mailing Address - Phone:305-333-3900
Mailing Address - Fax:
Practice Address - Street 1:7710 NW 71ST CT STE 206
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2931
Practice Address - Country:US
Practice Address - Phone:305-333-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-11
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW198561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical