Provider Demographics
NPI:1053801159
Name:BAILEY, YAMEEKA (LCPC)
Entity type:Individual
Prefix:
First Name:YAMEEKA
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4227 QUIGLEY CT
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-1520
Mailing Address - Country:US
Mailing Address - Phone:202-760-0772
Mailing Address - Fax:
Practice Address - Street 1:4227 QUIGLEY CT
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-1520
Practice Address - Country:US
Practice Address - Phone:202-760-0772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-14
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC8217101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD812895851Medicaid