Ryan Joseph Stivers, PH.D., LMFT, LPC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

166001032 Issued in IL

Practice address

1717 W Candletree Dr
Ste. B
Peoria, IL 61614-1592

Phone

(309) 713-1485

NPI assigned

Jun 15, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Summit Family Therapy PLLC

  • Professional Counselor
  • Peoria, IL
  • NPI 1548704372
  NPD

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

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477958400000",
    "number": "1316268113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10286",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616120286",
            "telephone_number": "309-713-1485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 W CANDLETREE DR",
            "address_2": "STE. B",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141592",
            "telephone_number": "309-713-1485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIVERS",
        "first_name": "RYAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "PH.D., LMFT, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-15",
        "last_updated": "2016-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P1111086",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "AR",
            "license": "M1206007",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166001032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182287795",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kari A Stewart, APN
• Sidney A Stewart, M.D.
• Michelle Lynn Stickelmaier, APN
• Gabriel J Stickling, O.T.
• Courtney Leigh Stivers, PHD, LMFT
• Adam John Stocksiek
• Joseph S Stocksiek
• Michelle Stoecker, DPT
• Jessica Christine Stokowski, RN, IBCLC
• Ryan Stoller

• Marriage & Family Therapist in Peoria, IL
• Providers in Peoria, IL by specialty
• Marriage & Family Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; 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.