Provider Demographics
NPI:1548049844
Name:SMALLEY, BAILEY JEANNE (LMFT-T)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:JEANNE
Last Name:SMALLEY
Suffix:
Gender:F
Credentials:LMFT-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1409
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65102-1409
Mailing Address - Country:US
Mailing Address - Phone:913-453-6269
Mailing Address - Fax:
Practice Address - Street 1:131 W HIGH ST # 1409
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65101-1714
Practice Address - Country:US
Practice Address - Phone:913-453-6269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS03547106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist