Ryan Carboneau, LPC
Individual provider Active NPI Professional Counselor · Lansdowne, VA
NPI 1336735943 · NPPES record last updated Dec 17, 2020
Key facts
- NPI
- 1336735943
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 0701009765 (VA)
- Practice address
- 44135 Woodridge Pkwy Ste 260
Lansdowne, VA 20176-1244 - Phone
- (571) 207-9756
- NPI assigned
- Dec 17, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701009765 | VA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Testudo Recovery Inc | Professional | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0701009765 | VA | Yes |
Addresses
Primary practice location
44135 Woodridge Pkwy Ste 260
Lansdowne, VA 20176-1244
Mailing address
44135 Woodridge Pkwy Ste 260
Lansdowne, VA 20176-1244
Phone (571) 207-9756
Other providers in Lansdowne, VA
- Laura Bowling-Nguyen
- Jasmit Singh Brar
- Chelsey Brooks
- Megan Bureau
- Shannon Marie Butler
- Anna Blue Catlett
- Centers for Advanced Orthopaedics, LLC
- Mrunalini A Chakurkar
- Banti D Chand
- Christina Eunha Choi Chang
All providers in Lansdowne, VA · Professional Counselor in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.