Active NPI
Sally Ryan, PH.D
- Mental Health Counselor
- Ada, MI
National Provider Identifier
1275703316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 005532
- Practice address
- 983 Spaulding Ave SE
Ada, MI 49301-3701 - Phone
- (616) 956-7878
- NPI assigned
- Mar 5, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 005532 | MI | Primary |
Addresses
Primary practice location
983 Spaulding Ave SE
Ada, MI 49301-3701
Mailing address
983 Spaulding Ave SE
Ada, MI 49301-3701
Phone (616) 956-7878
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 620D1-4555 | Other | MI | BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005532 | MI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204675200000",
"number": "1275703316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "983 SPAULDING AVE SE",
"city": "ADA",
"state": "MI",
"postal_code": "493013701",
"telephone_number": "616-956-7878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "983 SPAULDING AVE SE",
"city": "ADA",
"state": "MI",
"postal_code": "493013701",
"telephone_number": "616-956-7878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "SALLY",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-05",
"last_updated": "2008-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MI",
"license": "005532",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "620D1-4555",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ada, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.