1497114417 NPI number — BRITTANY R PRYCE LCSW, CADCI

Table of content: BRITTANY R PRYCE LCSW, CADCI (NPI 1497114417)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497114417 NPI number — BRITTANY R PRYCE LCSW, CADCI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PRYCE
Provider First Name:
BRITTANY
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW, CADCI
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497114417
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/29/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1417 PROGRESS LOOP
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LA GRANDE
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97850-3826
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-962-0162
Provider Business Mailing Address Fax Number:
541-962-0019

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
506 4TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LA GRANDE
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97850-1906
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-663-3138
Provider Business Practice Location Address Fax Number:
541-975-5120
Provider Enumeration Date:
02/18/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  L7692 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YA0400X , with the licence number: 17-06-34 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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