NPIMap

Organization Active NPI

Ryan Rehabilitation LLC

  • Addiction (Substance Use Disorder) Counselor
  • College Park, MD
National Provider Identifier
1104391317
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
RYAN REHABILITATION LLC
Doing business as
Ryan Rehabilitation, LLC
Practice address
7100 Baltimore Ave Ste 105
College Park, MD 20740-3652
Phone
(301) 209-9200
Fax
(301) 209-9202
NPI assigned
Oct 4, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Authorized official

Name
Melanie Suthard
Title
Billing Manager
Phone
(301) 942-9773

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X Primary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X

Addresses

Primary practice location

7100 Baltimore Ave Ste 105
College Park, MD 20740-3652

Mailing address

19630 Club House Rd Ste 715
Montgomery Village, MD 20886-3040
Phone (301) 258-7771

Other names 1

  • Ryan Rehabilitation, LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ryan Rehabilitation LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1104391317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19630 CLUB HOUSE RD STE 715",
            "city": "MONTGOMERY VILLAGE",
            "state": "MD",
            "postal_code": "208863040",
            "telephone_number": "301-258-7771",
            "fax_number": "301-258-9078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 BALTIMORE AVE STE 105",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207403652",
            "telephone_number": "301-209-9200",
            "fax_number": "301-209-9202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-04",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "SUTHARD",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "301-942-9773"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ryan Rehabilitation, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in College Park, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.