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General NPI Number Information
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NPI Number | 1730452178
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Entity Type | Individual
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Provider Name | CATHERINE RYAN L.C.P.C.
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Gender | Female
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Dates
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Enumeration Date | 02/15/2012
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Last Update Date | 12/06/2021
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Provider Practice Location Address
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Address Line | 964 N 5TH AVE
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City | SAINT CHARLES
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State | IL
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Zip | 60174-1204
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Country | US
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Telephone | 630-938-6858
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Fax |
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Provider Business Mailing Address
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Address Line | 1119 OXFORD CIR
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City | SYCAMORE
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State | IL
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Zip | 60178-1257
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Country | US
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Telephone | 630-247-9586
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 180.009109
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 178-007645
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License Number State | IL
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