John A Ryan, PH.D.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6301002572 Issued in MI

Practice address

22811 Greater Mack Ave
Suite L-3
Saint Clair Shores, MI 48080-2021

Phone

(586) 777-3988

Fax

(586) 777-9879

NPI assigned

Oct 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Lakeshore Psychological Services

  • Mental Health Counselor
  • Saint Clair Shores, MI
  • NPI 1508927658
  NPD (past) Authorized official

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164506341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 KENSINGTON AVE",
            "city": "GROSSE POINTE PARK",
            "state": "MI",
            "postal_code": "482301405",
            "telephone_number": "313-884-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22811 GREATER MACK AVE",
            "address_2": "SUITE L-3",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802021",
            "telephone_number": "586-777-3988",
            "fax_number": "586-777-9879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6301002572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rudy J Vervaeke MD PLC
• Marla Kay Ruhana, LMSW
• Chelsea Rumohr
• Carey Ryan, PT
• Jane K Ryan, LMSW
• Mistie D Ryan
• Miranda Rysiewicz, PT, DPT
• Richard T Saady, LMT
• Davis Brian Sabo
• Sacred Heart Rehabilitation Center, Inc.

• Mental Health Counselor in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.