Ryan Robert Wood, LCSW, ICADC, CADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW022247 Issued in PA

Practice address

956 W 38TH St
Erie, PA 16508-2531

Phone

(814) 528-5000

NPI assigned

Jul 30, 2020

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 13, 2023 through Dec 13, 2027

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Roots Counseling and Wellness, LLC

  • Clinical Social Worker
  • Erie, PA
  • NPI 1134873474
  NPD Authorized official

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

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1053920595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "956 W 38TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165082531",
            "telephone_number": "814-528-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "956 W 38TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165082531",
            "telephone_number": "814-528-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "RYAN",
        "middle_name": "ROBERT",
        "credential": "LCSW, ICADC, CADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-30",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.161934",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW022247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Womens Care Center of Erie County Inc
• Lisa Ann Wonderling
• Stephanie Pui-Kei Wong, FNP-C
• Christian Wood, O.D.
• Katie Elizabeth Wood, LCSW
• Stacy Wood
• Susan Wood, PHARMD
• Charles Woodard, CADC, ICADC
• Karen L Woodard, APRN,BC
• Taylor Monet Woodcock

• Clinical Social Worker in Erie, PA
• Providers in Erie, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.