Individual
ERIC C BAILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, CAC III
Contact information
Practice address
700 BROADWAY, DENVER, CO 80203-3421
(303) 367-2900
Mailing address
2585 HOLLY ST, DENVER, CO 80207-3227
(720) 225-6158
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2284
CO
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
4447
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AB30627
EMPLOYEE ID
CO
Enumeration date
03/22/2007
Last updated
01/08/2008
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