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General NPI Number Information
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NPI Number | 1790661015
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Entity Type | Individual
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Provider Name | ALYSSA HARRIS DEAN LAC
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Gender | Female
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Dates
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Enumeration Date | 08/13/2025
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 804 W FREEMAN AVE STE 9
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City | BERRYVILLE
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State | AR
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Zip | 72616-3141
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Country | US
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Telephone | 870-340-2636
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Fax |
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Provider Business Mailing Address
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Address Line | 206 BAKER ST APT A1
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City | BERRYVILLE
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State | AR
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Zip | 72616-3800
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Country | US
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Telephone | 479-981-6993
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | A2508009
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A2508009
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | A2508009
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License Number State | AR
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Taxonomy #4
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | A2508009
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License Number State | AR
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