Bailey Behavioral Health, Llc | |
34 W Grand Ave Ste 101 Fox Lake IL 60020-1224 | |
(847) 322-2975 | |
Not Available |
Full Name | Bailey Behavioral Health, Llc |
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Speciality | Counselor |
Location | 34 W Grand Ave Ste 101, Fox Lake, Illinois |
Authorized Official Name and Position | Diane M Bailey Yoder (OWNER, PROVIDER) |
Authorized Official Contact | 8473222975 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Bailey Behavioral Health, Llc 25663 W Brooks Farm Rd Round Lake IL 60073-5250 Ph: (847) 322-2975 | Bailey Behavioral Health, Llc 34 W Grand Ave Ste 101 Fox Lake IL 60020-1224 Ph: (847) 322-2975 |
NPI Number | 1790258408 |
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Provider Enumeration Date | 01/04/2019 |
Last Update Date | 01/04/2019 |
Medicare PECOS PAC ID | 0547681058 |
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Medicare Enrollment ID | O20200608002967 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790258408 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
Provider Name | Diane M Bailey Yoder |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1063833796 PECOS PAC ID: 7911253836 Enrollment ID: I20240221003285 |
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