Individual
KEICIA BETH BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
26 N LIBERTY ST, ASHEVILLE, NC 28801-1823
(336) 725-8389
Mailing address
665 W 4TH ST, WINSTON SALEM, NC 27101-2701
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1684
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C008398
LCSW
NC
Enumeration date
09/17/2013
Last updated
09/17/2013
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