Healthcare Provider Details

I. General information

NPI: 1528800372
Provider Name (Legal Business Name): ALYSSA RAILEY BRYANT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2024
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 OSBORNE WAY STE B
GEORGETOWN KY
40324-9636
US

IV. Provider business mailing address

2901 PIGEON ROOST RD
RUSH KY
41168-8132
US

V. Phone/Fax

Practice location:
  • Phone: 502-735-0400
  • Fax: 606-547-4295
Mailing address:
  • Phone: 606-928-6648
  • Fax: 606-928-1056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number259089
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: