Individual
MARK BAILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW, BCD
Contact information
Practice address
1502 W NC HIGHWAY 54, SUITE 603, DURHAM, NC 27707-5571
(919) 419-3110
Mailing address
1502 W NC HIGHWAY 54, SUITE 603, DURHAM, NC 27707-5571
(919) 419-3110
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
209
NC
1041C0700X
Clinical Social Worker
209
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12658
BLUE CROSS BLUE SHIELD NC
NC
01
—
M-101843
MANAGED HELATH NETWORK
NC
Enumeration date
01/18/2007
Last updated
09/11/2025
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