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General NPI Number Information
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NPI Number | 1720792146
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Entity Type | Individual
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Provider Name | RENEE RYAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/10/2023
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 72 PARK ST STE 206207
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City | NEW CANAAN
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State | CT
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Zip | 06840-4532
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Country | US
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Telephone | 917-697-5561
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Fax |
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Provider Business Mailing Address
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Address Line | 61 SHERWOOD LN
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City | NEW CANAAN
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State | CT
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Zip | 06840-3523
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Country | US
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Telephone | 917-697-5561
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 118127
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 16282
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License Number State | CT
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