Provider Demographics
NPI:1902138076
Name:SAAL, BAILEY (LISW)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:
Last Name:SAAL
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50125-2802
Mailing Address - Country:US
Mailing Address - Phone:515-961-2400
Mailing Address - Fax:515-961-7369
Practice Address - Street 1:1202 E 2ND AVE
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:IA
Practice Address - Zip Code:50125-2802
Practice Address - Country:US
Practice Address - Phone:515-961-2400
Practice Address - Fax:515-961-7369
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-01
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0070631041S0200X
IA70631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool