Tanya Ryan, LCSW
Individual provider Active NPI Clinical Social Worker · Coeur D Alene, ID
NPI 1225593288 · NPPES record last updated Oct 12, 2023
Key facts
- NPI
- 1225593288
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LCSW-42941 (ID)
- Practice address
- 1044 Northwest Blvd Ste C
Coeur D Alene, ID 83814-2114 - Phone
- (208) 930-1740
- Fax
- (208) 930-1695
- NPI assigned
- Feb 4, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ambitions of Idaho Inc
Practice addresses (Care Compare)
1044 Northwest Blvd
Suite C
Coeur D Alene, ID 83814-2114
Phone (208) 930-1740
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231017002440 | ID | Practitioner - Clinical Social Worker | 3779938337 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMSW-37762 | ID | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ambitions of Idaho, Inc. | Current |
Accepting new patients | |
| Ambitions of Idaho, Inc | Clinical | Current |
Accepting new patients |
| Psychiatric Associates Services PLLC | Past |
Accepting new patients |
Locations
1044 Northwest Blvd
Ste C
Coeur D Alene, ID 83814
Phone (208) 667-7777
1044 Northwest Blvd
Coeur D Alene, ID 83814
Phone (208) 917-1842
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LMSW-37762 | ID | |
| Clinical Social Worker | 1041C0700X | LCSW-42941 | ID | Yes |
Addresses
Primary practice location
1044 Northwest Blvd Ste C
Coeur D Alene, ID 83814-2114
Mailing address
1044 Northwest Blvd Ste C
Coeur D Alene, ID 83814-2114
Phone (208) 930-1740
Other providers in Coeur D Alene, ID
- Suzanne Jenkins Russell
- Alanna Caitlin Russo
- Alison Lee Ruygrok
- Ryan Averett DPM PC
- Mary Whitney Ryan
- Thomas P Ryan
- Aaron Sadowsky
- David Marshal Saelens
- Safe Harbor Counseling Center LLC
- Safe Waters Mental Recovery PLLC
All providers in Coeur D Alene, ID · Clinical Social Worker in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 12, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.