1396238432 NPI number — CINDI R BAILEY MSW,LSW

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396238432 NPI number — CINDI R BAILEY MSW,LSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BAILEY
Provider First Name:
CINDI
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSW,LSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396238432
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/09/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2845 BELL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ZANESVILLE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43701-1720
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-454-9766
Provider Business Mailing Address Fax Number:
740-588-6452

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2500 JOHN GLENN HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMBRIDGE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43725-9028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-439-4428
Provider Business Practice Location Address Fax Number:
740-439-3389
Provider Enumeration Date:
06/13/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  S.2001303-TRNE , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 104100000X , with the licence number: S.2106776 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0296119 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0390986 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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