LYLE PRATHER LAC NPI 1003010430

Specialist in Craig, CO

About LYLE PRATHER

Lyle Prather is a provider in Craig, CO. The NPI number assigned to this provider is 1003010430. The practitioner's primary taxonomy code is Specialist (174400000X). The provider is registered as an individual and their NPI record was last updated 11 years ago.

NPI1003010430 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Name LYLE PRATHER LAC
Provider Location Address2045 W VICTORY WAY CRAIG, CO 81625 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address2045 W VICTORY WAY CRAIG, CO 81625 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
GenderMale
NPI Entity TypeIndividual Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?Yes
Is Organization Subpart?N/A Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date06-11-2007 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date07-08-2007 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

LYLE PRATHER LAC
2045 W VICTORY WAY
CRAIG, CO
ZIP 81625
Phone: (970) 824-2557
Fax: (970) 824-2412
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Mailing Address

LYLE PRATHER LAC
2045 W VICTORY WAY
CRAIG, CO
ZIP 81625
Phone: (970) 824-2557
Fax: (970) 824-2412

Primary Taxonomy

Taxonomy Code174400000X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationSpecialist
TypeOther Service Providers
License No.73
License StateCO
Taxonomy DescriptionAn individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Map Location


LYLE PRATHER LAC address is 2045 W VICTORY WAY CRAIG, CO 81625

Other Providers at the same location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1235349747 LYNEA R ELLGEN M.S.W, L.S.W
Individual
Specialist2045 W VICTORY WAY
CRAIG, CO 81625
(970) 824-2557
1689897183YAMPA VALLEY PSYCHOTHERAPISTS
Organization
Specialist2045 W VICTORY WAY
CRAIG, CO 81625
(970) 824-2557
1992928485 GARY F GURNEY L.P.C.
Individual
Specialist2045 W VICTORY WAY
CRAIG, CO 81625
(970) 824-2557