Kevin Thomas Ryan, M.A., MFCT, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

T0405 Issued in OR

Practice address

119 E 2ND St Ste 216
The Dalles, OR 97058-1796

Phone

(541) 296-6114

Fax

(541) 296-6577

NPI assigned

Oct 24, 2007

Last updated

Feb 16, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kevin Ryan PC

  • Adult Mental Health Clinic/Center
  • The Dalles, OR
  • NPI 1972139947
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329350400000",
    "number": "1033398284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 E 2ND ST STE 216",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970581796",
            "telephone_number": "541-296-6114",
            "fax_number": "541-296-6577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 E 2ND ST STE 216",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970581796",
            "telephone_number": "541-296-6114",
            "fax_number": "541-296-6577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "KEVIN",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "M.A.,  MFCT, LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-24",
        "last_updated": "2012-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T0405",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC31395",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Michelle Rosenberg
• Molly Kate Routson, L.M.T.
• Shaun Rovig
• Meghan Rowland
• Erin Rust, QMHP
• Nader Saad, PHARMD
• Jennifer Sabo, PT
• Joseph Santo Sacamano, M.D.
• Safeway Inc (Safeway Pharmacy #1489)
• Sage Adult and Geriatric Primary Care LLC

• Marriage & Family Therapist in The Dalles, OR
• Providers in The Dalles, OR by specialty
• Marriage & Family Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.