Basic Information
| Provider Information | |||||||||
| NPI: | 1356869911 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAYLESS | ||||||||
| FirstName: | JILL | ||||||||
| MiddleName: | ARLENE | ||||||||
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| Credential: | LPC | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 600 MAIN STREET | ||||||||
| Address2: | |||||||||
| City: | HOT SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 71913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5013218200 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 600 MAIN STREET | ||||||||
| Address2: | |||||||||
| City: | HOT SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 71913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5013218200 | ||||||||
| FaxNumber: | 5013218202 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/05/2017 | ||||||||
| LastUpdateDate: | 02/05/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | P1901008 | AR | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.