Active NPI
Alicia Wassenich O'Bryan, LSW, LICDC
- Social Worker
- Dayton, OH
National Provider Identifier
1629556766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.2207896
- Practice address
- 257 Hopeland St BLDG B
Dayton, OH 45417-3420 - Phone
- (937) 535-8101
- Fax
- (937) 222-7657
- NPI assigned
- Jul 31, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S.2207896 | OH | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LICDC.162657 | OH |
Addresses
Primary practice location
257 Hopeland St BLDG B
Dayton, OH 45417-3420
Mailing address
257 Hopeland St BLDG B
Dayton, OH 45417-3420
Phone (937) 535-8101
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LICDC.162657 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| S.2207896 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736553600000",
"number": "1629556766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "257 HOPELAND ST BLDG B",
"city": "DAYTON",
"state": "OH",
"postal_code": "454173420",
"telephone_number": "937-535-8101",
"fax_number": "937-222-7657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "257 HOPELAND ST BLDG B",
"city": "DAYTON",
"state": "OH",
"postal_code": "454173420",
"telephone_number": "937-535-8101",
"fax_number": "937-222-7657"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'BRYAN",
"first_name": "ALICIA",
"middle_name": "WASSENICH",
"credential": "LSW, LICDC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-31",
"last_updated": "2025-01-11",
"certification_date": "2025-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.2207896",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "LICDC.162657",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.