Active NPI
Ryan Willard, PHD
- Psychologist
- Baltimore, MD
National Provider Identifier
1609613694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 07190
- Practice address
- 320 S Collington Ave
Baltimore, MD 21231-2732 - Phone
- (240) 520-4493
- NPI assigned
- Jul 9, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 07190 | MD | Primary |
Addresses
Primary practice location
320 S Collington Ave
Baltimore, MD 21231-2732
Mailing address
1525 Greenspring Valley Rd
Stevenson, MD 21153-0641
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 07190 | MD | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720483200000",
"number": "1609613694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1525 GREENSPRING VALLEY RD",
"city": "STEVENSON",
"state": "MD",
"postal_code": "211530641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 S COLLINGTON AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212312732",
"telephone_number": "240-520-4493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLARD",
"first_name": "RYAN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-07-09",
"last_updated": "2024-07-09",
"certification_date": "2024-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MD",
"license": "07190",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.