Andrew David Ryan

Individual provider Active NPI Social Worker · New Bloomfield, PA

NPI 1104657576 · NPPES record last updated Aug 8, 2024

Key facts

NPI
1104657576
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
License
SW140260 (PA)
Practice address
115 N Carlisle St
New Bloomfield, PA 17068-9660
Phone
(717) 582-2051
NPI assigned
Aug 8, 2024
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SW140260PAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fresh Start Counseling Center, LLC Past
since Aug 11, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW140260 PA Yes

Addresses

Primary practice location

115 N Carlisle St
New Bloomfield, PA 17068-9660

Mailing address

115 N Carlisle St
New Bloomfield, PA 17068-9660
Phone (717) 582-2051

Other providers in New Bloomfield, PA

All providers in New Bloomfield, PA · Social Worker in Pennsylvania

Sources for this page

Verify at the official NPI Registry.