Individual
CLARICE BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
U
Credential
MA, LADC, LPCC
Contact information
Practice address
520 OSBORNE RD NE, FRIDLEY, MN 55432-2718
(763) 236-4528
Mailing address
520 OSBORNE RD NE, FRIDLEY, MN 55432-2718
(763) 236-4528
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
305049
MN
101YM0800X
Mental Health Counselor
Primary
CC04387
MN
2084P0800X
Psychiatry Physician
04387
MN
Other
Enumeration date
05/13/2024
Last updated
06/25/2024
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