Shirley Ann Ryan, MS, LMHC, LMFTA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

85000067A Issued in IN

Practice address

2525 Lake Ave
Fort Wayne, IN 46805-5407

Phone

(260) 484-4153

NPI assigned

Apr 10, 2011

Sex

Female

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)

Not enrolled

Credentials

Master of Science

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.

• Crossroad - Fort Wayne Childrens Home

  • Adolescent and Children Mental Health Clinic/Center
  • Fort Wayne, IN
  • NPI 1275614109
  NPD (past)
• Crossroad Child & Family Services, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Fort Wayne, IN
  • NPI 1699868893
  NPD (past)

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

{
    "created_epoch": "1302393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427500800000",
    "number": "1679863880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6722 CANBY DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468351615",
            "telephone_number": "260-402-0334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055407",
            "telephone_number": "260-484-4153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "SHIRLEY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MS, LMHC, LMFTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-10",
        "last_updated": "2015-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "85000067A",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39002614A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• RX Holdings, LLC
• Ryan Beeching Counseling LLC
• Jessica Lee Ryan
• Peggy A Ryan, APRN,BC,ANP
• Sayge Ryan, CTRS
• Thomas P Ryan, DO
• Christina Ryder, MS, LAT, ATC
• Benjamin Charles Ryman, PHARMD
• S.T.a.R. Care Services, LLC
• Abdo Maroun Saad, MD

• Marriage & Family Therapist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Marriage & Family Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2015; 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.