Individual provider Active NPI

Sean Michael Ryan, LPC

  • Professional Counselor
  • Milwaukee, WI
National Provider Identifier
1437325610
Registry record updated May 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3967-125 Issued in WI
Practice address
620 S 76TH St
Suite 120
Milwaukee, WI 53214-1549
Phone
(414) 231-4846
Fax
(414) 453-2538
NPI assigned
May 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 3967-125 WI Primary

Addresses

Primary practice location

620 S 76TH St
Suite 120
Milwaukee, WI 53214-1549

Mailing address

620 S 76TH St
Suite 120
Milwaukee, WI 53214-1549
Phone (414) 231-4846

Other identifiers 1

IdentifierTypeStateIssuer
40928000MedicaidWI

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3967-125WIMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210118400000",
    "number": "1437325610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 S 76TH ST",
            "address_2": "SUITE 120",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532141549",
            "telephone_number": "414-231-4846",
            "fax_number": "414-453-2538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 S 76TH ST",
            "address_2": "SUITE 120",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532141549",
            "telephone_number": "414-231-4846",
            "fax_number": "414-453-2538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "SEAN",
        "middle_name": "MICHAEL",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-07",
        "last_updated": "2008-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3967-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40928000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; 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.