Healthcare Provider Details

I. General information

NPI: 1649486838
Provider Name (Legal Business Name): JANE RICE BYE MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 ALEUTIAN AVENUE OONALASKA WELLNESS CENTER BEHAVIORAL HEALTH
UNALASKA AK
99685
US

IV. Provider business mailing address

PO BOX 921169
DUTCH HARBOR AK
99692-1169
US

V. Phone/Fax

Practice location:
  • Phone: 907-581-2751
  • Fax: 907-581-2752
Mailing address:
  • Phone: 907-581-2751
  • Fax: 907-581-2752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number769
License Number StateAK

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: