MEDICARE: ALLISON MARGARET RYAN LSW

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	1041C0700X	Clinical Social Worker	I.2506286	OH
2	104100000X	Social Worker	S.1904495	OH

General Provider Information

NPI Number	:	1669011797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON MARGARET RYAN LSW

Provider Business Mailing Address
First Line	:	610 N MAIN ST
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-2007
Country	:	US
Telephone Number	:	330-936-0438
Fax Number	:	234-425-5843

Provider Business Practice Location Address
First Line	:	610 N MAIN ST
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-2007
Country	:	US
Telephone Number	:	330-353-8667
Fax Number	:	234-425-5843

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

Provider Enumeration Date	:	01/07/2020
Last Update Date	:	12/09/2025

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