=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194098459
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | C. RYAN CONSULTING, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/17/2012
-----------------------------------------------------
Last Update Date | 10/15/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4480 SPRING HILL DR
-----------------------------------------------------
City | SCHNECKSVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18078-2543
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-939-5193
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4480 SPRING HILL DR P.O. BOX 132
-----------------------------------------------------
City | SCHNECKSVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18078-2543
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-939-5193
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/ LPC
-----------------------------------------------------
Name | WILLIAM E COOPER
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 610-393-5193
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | PC001847
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------