Provider Demographics
NPI:1053938266
Name:PARIS, BAILEY KENDRICK (LMSW)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:KENDRICK
Last Name:PARIS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CHRISTIN
Other - Middle Name:BAILEY
Other - Last Name:KENDRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1311 ROCKING CHAIR CT
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-2456
Mailing Address - Country:US
Mailing Address - Phone:229-848-7738
Mailing Address - Fax:
Practice Address - Street 1:4343 SHALLOWFORD RD STE 410
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-5067
Practice Address - Country:US
Practice Address - Phone:678-384-4911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-03
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW0114451041C0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program