Provider Demographics
NPI:1215970454
Name:BYARLAY, DANIEL D (LSCSW)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:D
Last Name:BYARLAY
Suffix:
Gender:M
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 E BETHEL CIR
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-8952
Mailing Address - Country:US
Mailing Address - Phone:785-667-6311
Mailing Address - Fax:
Practice Address - Street 1:511 NE 10TH ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:KS
Practice Address - Zip Code:67410-2153
Practice Address - Country:US
Practice Address - Phone:785-263-6848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLSCSW 12541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS11655065OtherCAQH
32753OtherCIGNA
92085OtherMANAGED HEALTH NETWORK
KS100097970AMedicaid
KS200436420AOtherKMAP
KS006933OtherMEDICARE
32753OtherCIGNA
KS011571Medicare PIN