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NPI Code Detail

MEDICARE: KATHLEEN RYAN

MEDICARE:   KATHLEEN  RYAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor016687NY

General Provider Information

NPI Number : 1922925767
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN RYAN
Provider Business Mailing Address
First Line : 19 SWEET POND CT
Second Line :
City : BLUFFTON
State : SC
Zip : 29910-9582
Country : US
Telephone Number : 516-317-2089
Fax Number :
Provider Business Practice Location Address
First Line : 25 TABBY SHELL RD
Second Line : GARAGE APT.
City : BLUFFTON
State : SC
Zip : 29910-5508
Country : US
Telephone Number : 516-317-2089
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2026
Last Update Date : 07/02/2026

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Directions to “ KATHLEEN RYAN ” Practice Location

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