Individual
SUSAN A BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
116 HILLS PLZ, CHARLESTON, WV 25387-2438
(304) 720-4466
(304) 720-4821
Mailing address
97 GREAT TEAYS BLVD STE 6, SCOTT DEPOT, WV 25560-9816
(304) 757-6999
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2459
WV
101YP2500X
Professional Counselor
Primary
2459
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174164115
—
WV
Enumeration date
10/01/2019
Last updated
06/19/2020
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