Provider Demographics
NPI:1790773687
Name:BYLER, JASON L (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:L
Last Name:BYLER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14021 N 51ST AVE
Mailing Address - Street 2:SUITE 118
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-4838
Mailing Address - Country:US
Mailing Address - Phone:602-843-5484
Mailing Address - Fax:602-843-5498
Practice Address - Street 1:14021 N 51ST AVE
Practice Address - Street 2:SUITE 118
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4838
Practice Address - Country:US
Practice Address - Phone:602-843-5484
Practice Address - Fax:602-843-5498
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-05431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical