Provider Demographics
NPI:1053600619
Name:BAILEY, MADELYNE S
Entity type:Individual
Prefix:MS
First Name:MADELYNE
Middle Name:S
Last Name:BAILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MADELYNE
Other - Middle Name:G
Other - Last Name:STRAUSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26 WEST 9TH ST. SUITE 3-C
Mailing Address - Street 2:1 CHRISTOPHER ST. SUITE 1-A
Mailing Address - City:NEW YORK CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10011
Mailing Address - Country:US
Mailing Address - Phone:917-721-9195
Mailing Address - Fax:
Practice Address - Street 1:26 WEST 9TH ST. SUITE 3-C
Practice Address - Street 2:1 CHRISTOPHER ST. SUITE 1-A
Practice Address - City:NYC
Practice Address - State:NY
Practice Address - Zip Code:10011
Practice Address - Country:US
Practice Address - Phone:917-721-9195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP0203901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY11900213OtherCAQN
NYP020390OtherNY STATE