MEDICARE: MR. STEPHEN O RYAN LMHC

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
1	101YM0800X	Mental Health Counselor	MH 7827	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	273239	OTHER	FL	WELLCARE PROVIDER NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1851663496	OTHER	FL	GROUP NPI
4	1628174	OTHER	FL	CIGNA PROVIDER #
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619180593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEPHEN O RYAN LMHC

Provider Business Mailing Address
First Line	:	6150 METROWEST BLVD
Second Line	:	SUITE # 103
City	:	ORLANDO
State	:	FL
Zip	:	32835-3289
Country	:	US
Telephone Number	:	407-730-3837
Fax Number	:	407-730-3869

Provider Business Practice Location Address
First Line	:	6150 METROWEST BLVD
Second Line	:	SUITE # 103
City	:	ORLANDO
State	:	FL
Zip	:	32835-3289
Country	:	US
Telephone Number	:	407-730-3837
Fax Number	:	407-730-3869

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	05/12/2015

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Directions to “ MR. STEPHEN O RYAN LMHC” Practice Location

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