Healthcare Provider Details

I. General information

NPI: 1700706249
Provider Name (Legal Business Name): RYLIE JAMES BAIR LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

1003 GREENE AVE APT 5I
BROOKLYN NY
11221-6223
US

IV. Provider business mailing address

1003 GREENE AVE APT 5I
BROOKLYN NY
11221-6223
US

V. Phone/Fax

Practice location:
  • Phone: 360-526-1347
  • Fax: 360-526-1347
Mailing address:
  • Phone: 360-526-1347
  • Fax: 360-526-1347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number018208
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: