Provider Demographics
NPI:1639456593
Name:DRYE, ROCIO G (LCSW)
Entity Type:Individual
Prefix:
First Name:ROCIO
Middle Name:G
Last Name:DRYE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ROCIO
Other - Middle Name:G
Other - Last Name:DRYE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 247
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-0247
Mailing Address - Country:US
Mailing Address - Phone:951-845-3155
Mailing Address - Fax:951-922-6955
Practice Address - Street 1:101 E NICOLET ST
Practice Address - Street 2:
Practice Address - City:BANNING
Practice Address - State:CA
Practice Address - Zip Code:92220-5551
Practice Address - Country:US
Practice Address - Phone:951-922-0280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 171M00000X
CA1004941041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator