Healthcare Provider Details

I. General information

NPI: 1497114417
Provider Name (Legal Business Name): BRITTANY R PRYCE LCSW, CADCI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2016
Last Update Date: 11/29/2022
Certification Date: 11/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 4TH ST
LA GRANDE OR
97850-1906
US

IV. Provider business mailing address

1417 PROGRESS LOOP
LA GRANDE OR
97850-3826
US

V. Phone/Fax

Practice location:
  • Phone: 541-663-3138
  • Fax: 541-975-5120
Mailing address:
  • Phone: 541-962-0162
  • Fax: 541-962-0019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL7692
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number17-06-34
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: