Provider Demographics
NPI:1790661882
Name:BAILEY, JOSHUA JAMES
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:JAMES
Last Name:BAILEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1985 SE DUPONT ST
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-6724
Mailing Address - Country:US
Mailing Address - Phone:772-924-5119
Mailing Address - Fax:
Practice Address - Street 1:1985 SE DUPONT ST
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-6724
Practice Address - Country:US
Practice Address - Phone:772-924-5119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst