Provider Demographics
NPI:1548692726
Name:BAILEY, LISA EILEEN (LCSW)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:EILEEN
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1870 W SURREY PARK LN
Mailing Address - Street 2:1B
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-3475
Mailing Address - Country:US
Mailing Address - Phone:847-670-8410
Mailing Address - Fax:
Practice Address - Street 1:1320 TOWER RD
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4309
Practice Address - Country:US
Practice Address - Phone:847-598-3553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490158181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical