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General NPI Number Information
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NPI Number | 1538637871
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Entity Type | Organization
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Legal Business Name | RICHARD F. RYAN, PHD, LCSW
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Dates
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Enumeration Date | 11/05/2018
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Last Update Date | 10/21/2020
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Provider Practice Location Address
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Address Line | 1502 S SAINT FRANCIS DR
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City | SANTA FE
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State | NM
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Zip | 87505-4040
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Country | US
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Telephone | 505-310-8233
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Fax | 505-930-5419
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Provider Business Mailing Address
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Address Line | 1502 S SAINT FRANCIS DR
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City | SANTA FE
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State | NM
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Zip | 87505-4040
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Country | US
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Telephone | 505-310-8233
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Fax | 505-930-5419
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Authorized Official
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Title or Position | CEO
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Name | MR. RICHARD FRANCIS RYAN
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Credential | PHD LCSW
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Telephone | 505-983-5419
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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