Laronda Ruth Ayo, LMFT
Individual provider Active NPI Marriage & Family Therapist · Madison, WI
NPI 1346842432 · NPPES record last updated Dec 20, 2023
Key facts
- NPI
- 1346842432
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 266324 (KY)
- Practice address
- 1716 Fordem Ave
Madison, WI 53704-4604 - Phone
- (608) 221-3511
- Fax
- (608) 221-3514
- NPI assigned
- Nov 12, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Marriage and Family Therapist
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- Insight Mental Wellness PA
Practice addresses (Care Compare)
10807 Perrin Beitel Rd
Suite 300
San Antonio, TX 78217-3144
Phone (210) 245-7862
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250122003551 | TX | Practitioner - Marriage and Family Therapist | 4486183340 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 266324 | KY | MD | Marriage & Family Therapist |
| 205297 | TX | MD | Pharmacy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Insight Mental Wellness PA | Marriage & Family Therapist | Current |
Accepting new patients |
| Children'S Service Society of Wisconsin | Marriage & Family Therapist | Past |
Accepting new patients |
| Medvon Medical Clinic Professional Corporation | Past |
Accepting new patients |
Locations
10807 Perrin Beitel Rd
Ste 300
San Antonio, TX 78217
Phone (210) 245-7862
12915 Jones Maltsberger Rd
Ste 102
San Antonio, TX 78247
Phone (210) 245-7862
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 266324 | KY | Yes |
Addresses
Primary practice location
1716 Fordem Ave
Madison, WI 53704-4604
Mailing address
1957 E Main St
Madison, WI 53704-5227
Phone (502) 526-3542
Other practice location 1
4010 DuPont Cir Ste 582
Louisville, KY 40207-4888
Phone (502) 526-3542
Other providers in Madison, WI
- Gregory Jackson Aycock
- Ilayda Aydin
- Abigail Ayers
- Oghenetega Esther Ayisire-Salako
- Juliet L Aylward
- Benjamin Robert Ayres
- Az Care Transit LLC
- Az Homecare LLC
- Ali Azeem
- Najla Ba Sharahil
All providers in Madison, WI · Marriage & Family Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.