Ryan Nelson Cragg, LCPC, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LCPC-7552 Issued in ID

Practice address

403 W Cherry LN
Meridian, ID 83642-1610

Phone

(208) 887-1911

Fax

(208) 895-8049

NPI assigned

Jun 15, 2009

Last updated

Nov 28, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638057600000",
    "number": "1346477627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 W CHERRY LN",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421610",
            "telephone_number": "208-887-1911",
            "fax_number": "208-895-8049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 W CHERRY LN",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421610",
            "telephone_number": "208-887-1911",
            "fax_number": "208-895-8049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAGG",
        "first_name": "RYAN",
        "middle_name": "NELSON",
        "credential": "LCPC, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-15",
        "last_updated": "2021-11-28",
        "certification_date": "2021-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-7552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Meridian, ID
• Providers in Meridian, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2021; 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.