Provider Demographics
NPI:1689275950
Name:BAILEY, AMY (BS, CADCII, LAC, QHM)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:BS, CADCII, LAC, QHM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5223 SACAGAWEA DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-8912
Mailing Address - Country:US
Mailing Address - Phone:541-294-2463
Mailing Address - Fax:
Practice Address - Street 1:5223 SACAGAWEA DR
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-8912
Practice Address - Country:US
Practice Address - Phone:541-294-2463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR24-QHMA-I-004329101YM0800X
OR11-R-14101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty