Ryan James Ebersberger, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L12747 Issued in OR

Practice address

2265 Ashland St
Ashland, OR 97520-1490

Phone

(541) 830-1350

NPI assigned

Jul 9, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Rogue Community Health

  • Federally Qualified Health Center (FQHC)
  • Medford, OR
  • NPI 1073511721
  NPD (past)

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

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1558989285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 DISK DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975016638",
            "telephone_number": "541-773-3863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2265 ASHLAND ST",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975201490",
            "telephone_number": "541-830-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERSBERGER",
        "first_name": "RYAN",
        "middle_name": "JAMES",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-09",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P012875",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L12747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coeli Dwivedi, LDM, CPM
• Diane Dwyer
• Dynamic Health Partners, PC
• Luc Allen Dyssegard, LMT
• Marsha L Easterday, LMT
• Marjorie Edwards, PT
• Jennifer Upton Egan, LPC
• Tara Elder-Hammond
• Elements of Health Oregon, LLC
• Rebecca Rae Elgin

• Clinical Social Worker in Ashland, OR
• Providers in Ashland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; 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.