Bailes, Mark
Bailes, Mark is an sole proprietor health care provider with primary practice located at 1502 W Nc Highway 54 Suite 603, Durham NC 27707-5571. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Bailes, Mark can be contacted via phone (919) 419-3110.Contact Information
Primary practice address
1502 W Nc Highway 54 Suite 603
Durham NC 27707-5571
Phone: (919) 419-3110
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 209 | North Carolina |
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | 209 | North Carolina |
Profile Details
| NPI number | 1609928431 |
|---|---|
| LBN Legal business name | Bailes, Mark |
| Credentials | MSW, LCSW, BCD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 18th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609928431 | NPPES |
| North Carolina | Other | M-101843 | MANAGED HELATH NETWORK |
| North Carolina | Other | 12658 | MANAGED HELATH NETWORK |
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