Individual provider Active NPI

Rita Ryan Ryan, LCSW

  • Clinical Social Worker
  • Lake Wales, FL
National Provider Identifier
1356544654
Registry record updated Dec 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW5755 Issued in FL
Practice address
555 Burns Ave
Lake Wales, FL 33853-3335
Phone
(863) 679-3338
Fax
(863) 298-0299
NPI assigned
Jun 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW5755 FL Primary

Addresses

Primary practice location

555 Burns Ave
Lake Wales, FL 33853-3335

Mailing address

555 Burns Ave
Lake Wales, FL 33853-3335
Phone (863) 679-3338

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW5755FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Our Children'S Academy Past Accepting new patients
Winter Haven Hospital Inc PastSince Nov 24, 2019 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260144000000",
    "number": "1356544654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 BURNS AVE",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338533335",
            "telephone_number": "863-679-3338",
            "fax_number": "863-298-0299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 BURNS AVE",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338533335",
            "telephone_number": "863-679-3338",
            "fax_number": "863-298-0299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "RITA",
        "middle_name": "RYAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2009-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW5755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2009; 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.