Active NPI
Ryan Thomas Neace, MA, LPC, NCC, CCMHC
- Mental Health Counselor
- Poway, CA
National Provider Identifier
1003171984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 10406
- Practice address
- 14650 Deerwood St
Poway, CA 92064-6457 - Phone
- (858) 227-7719
- Fax
- (866) 596-5017
- NPI assigned
- Jul 7, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0701005000 | VA | |
| Professional Counselor | 101YP2500X | 2013014281 | MO | |
| Mental Health Counselor | 101YM0800X | 10406 | CA | Primary |
Addresses
Primary practice location
14650 Deerwood St
Poway, CA 92064-6457
Mailing address
14650 Deerwood St
Poway, CA 92064-6457
Phone (314) 879-4255
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12399247 | Other | CAQH PROVIDER ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2013014281 | MO | MD | Professional Counselor |
| 0701005000 | VA | MD | Professional Counselor |
| 10406 | CA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699401600000",
"number": "1003171984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14650 DEERWOOD ST",
"city": "POWAY",
"state": "CA",
"postal_code": "920646457",
"telephone_number": "314-879-4255",
"fax_number": "866-596-5017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14650 DEERWOOD ST",
"city": "POWAY",
"state": "CA",
"postal_code": "920646457",
"telephone_number": "858-227-7719",
"fax_number": "866-596-5017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEACE",
"first_name": "RYAN",
"middle_name": "THOMAS",
"credential": "MA, LPC, NCC, CCMHC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-07",
"last_updated": "2023-11-08",
"certification_date": "2023-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0701005000",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2013014281",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "10406",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH PROVIDER ID",
"identifier": "12399247",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Poway, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.