Provider Demographics
NPI:1730729294
Name:DYER, JAMES (CADC-I)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:DYER
Suffix:
Gender:M
Credentials:CADC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 E LONG ST STE 201
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-3106
Mailing Address - Country:US
Mailing Address - Phone:775-461-0999
Mailing Address - Fax:775-461-3006
Practice Address - Street 1:900 E LONG ST STE 201
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-3106
Practice Address - Country:US
Practice Address - Phone:775-461-0999
Practice Address - Fax:775-461-3006
Is Sole Proprietor?:No
Enumeration Date:2020-01-13
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV02356-I101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)