Provider Demographics
NPI:1568602985
Name:BYERS, AUTUMN CLARE BRADLEY (LCSW)
Entity Type:Individual
Prefix:
First Name:AUTUMN CLARE
Middle Name:BRADLEY
Last Name:BYERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:AUTUMN CLARE
Other - Middle Name:BRADLEY
Other - Last Name:MCCARTHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1533 N ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93728-1708
Mailing Address - Country:US
Mailing Address - Phone:559-312-3873
Mailing Address - Fax:
Practice Address - Street 1:1533 N ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93728-1708
Practice Address - Country:US
Practice Address - Phone:559-312-3873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-25
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX524811041C0700X
CA246731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical