Provider Demographics
NPI:1538495155
Name:DYE, BARBARA ANN (LPCC)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:DYE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5044
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87499
Mailing Address - Country:US
Mailing Address - Phone:970-375-6257
Mailing Address - Fax:505-564-4925
Practice Address - Street 1:475 E 20TH ST SUITE 4
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401
Practice Address - Country:US
Practice Address - Phone:505-325-3549
Practice Address - Fax:505-325-7803
Is Sole Proprietor?:No
Enumeration Date:2009-11-02
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM00856211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM71176748Medicaid