Ryan Timothy Flack, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0701013243 Issued in VA

Practice address

1454 Mexico Way NE
Roanoke, VA 24012-6476

Phone

(434) 533-1088

NPI assigned

Jan 24, 2024

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

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.

• Associates in Brief Therapy, Inc.

  • Professional Counselor
  • Roanoke, VA
  • NPI 1033286794
  NPD (past)
• Impact Living Services

  • Professional Counselor
  • Forest, VA
  • NPI 1487054342
  NPD (past)

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

{
    "created_epoch": "1706054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1568224731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6430 ARCHCREST DR APT 106",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240191185",
            "telephone_number": "540-580-6221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1454 MEXICO WAY NE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240126476",
            "telephone_number": "434-533-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLACK",
        "first_name": "RYAN",
        "middle_name": "TIMOTHY",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-24",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701013243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kiley F Fitzgerald, MD
• Mary Fitzgerald, CRNA
• Fielding Carter Fitzpatrick, DO
• Vicki Lee Fitzpatrick, PA-C
• Gretchen Renee Flack, LPC
• Sharon Flaminio, OTR
• Kristen Flanders, LCSW
• Jessica Lynn Fleming, DO
• William David Fleming, RPH
• Alec Chase Fletcher

• Mental Health Counselor in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.