Provider Demographics
NPI:1467035915
Name:BAILEY WHITCOMB, PHOEBE MYRIA (LSW)
Entity type:Individual
Prefix:
First Name:PHOEBE
Middle Name:MYRIA
Last Name:BAILEY WHITCOMB
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3475 CHESTER DR
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-2093
Mailing Address - Country:US
Mailing Address - Phone:254-400-0139
Mailing Address - Fax:
Practice Address - Street 1:3475 CHESTER DR
Practice Address - Street 2:
Practice Address - City:MACUNGIE
Practice Address - State:PA
Practice Address - Zip Code:18062-2093
Practice Address - Country:US
Practice Address - Phone:254-400-0139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-03
Last Update Date:2025-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW135865104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker