Active NPI
Katheryn Ryan, PHD
- Clinical Psychologist
- Quantico, VA
National Provider Identifier
1295197671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 05904
- Practice address
- 3259 Catlin Ave
Quantico, VA 22134-5109 - Phone
- (703) 784-1785
- NPI assigned
- Mar 24, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 05904 | MD | |
| Clinical Psychologist | 103TC0700X | 05904 | MD | Primary |
Addresses
Primary practice location
3259 Catlin Ave
Quantico, VA 22134-5109
Mailing address
714 King St Apt 310
Portsmouth, VA 23704-3463
Phone (571) 241-6185
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 |
|---|---|---|---|
| 05904 | MD | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712016000000",
"number": "1295197671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "714 KING ST APT 310",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237043463",
"telephone_number": "571-241-6185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3259 CATLIN AVE",
"city": "QUANTICO",
"state": "VA",
"postal_code": "221345109",
"telephone_number": "703-784-1785"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "KATHERYN",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-24",
"last_updated": "2024-04-02",
"certification_date": "2024-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MD",
"license": "05904",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "05904",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Quantico, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.