Bailey, Shannon Dale

Bailey, Shannon Dale is an individual health care provider with primary practice located at 105 Eastside Dr , Georgetown KY 40324-9797. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Bailey, Shannon Dale can be contacted via phone (502) 866-0664.

Contact Information

Primary practice address
105 Eastside Dr Georgetown KY 40324-9797
Phone: (502) 866-0664
Fax: (502) 866-0666
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 168771 Kentucky

Profile Details

NPI number 1073881744
LBN Legal business name Bailey, Shannon Dale
Credentials M.A., LCADC, CCS
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 8th, 2011
Last updated Jul 21st, 2023 - about last year

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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1073881744 NPPES
Kentucky Other 168771 LCADC
Kentucky MEDICAID 80236 LCADC

Popular Providers