Provider Demographics
NPI:1831450915
Name:PRYDE, RACHEL ARVELLA (LCSW)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ARVELLA
Last Name:PRYDE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:ARVELLA
Other - Last Name:JAYNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PCSW
Mailing Address - Street 1:1644 HIGHWAY 395 N
Mailing Address - Street 2:SUITE D
Mailing Address - City:MINDEN
Mailing Address - State:NV
Mailing Address - Zip Code:89423
Mailing Address - Country:US
Mailing Address - Phone:307-880-7224
Mailing Address - Fax:
Practice Address - Street 1:1644 HIGHWAY 395 N
Practice Address - Street 2:SUITE D
Practice Address - City:MINDEN
Practice Address - State:NV
Practice Address - Zip Code:89423
Practice Address - Country:US
Practice Address - Phone:307-880-7224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW794201041C0700X
WYLCSW-9301041C0700X
WYPCSW-4961041C0700X
WY4961041C0700X
NV8049-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical