Provider Demographics
NPI:1144232984
Name:GEASLIN BYLER, DANICA LEE ANN (LCPC)
Entity Type:Individual
Prefix:MS
First Name:DANICA
Middle Name:LEE ANN
Last Name:GEASLIN BYLER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 VALLEY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62234-6805
Mailing Address - Country:US
Mailing Address - Phone:618-540-9677
Mailing Address - Fax:
Practice Address - Street 1:1 VALLEY VIEW DR
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62234-6805
Practice Address - Country:US
Practice Address - Phone:618-540-9677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2023-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005297101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL06032019Medicare UPIN