Individual provider Active NPI

Ryan Vera, LCAC, LCPC

  • Addiction (Substance Use Disorder) Counselor
  • Lawrence, KS
National Provider Identifier
1699170738
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
17916 Issued in TX
Practice address
3205 Clinton Parkway CT
Lawrence, KS 66047-2627
Phone
(785) 843-5483
NPI assigned
Oct 31, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 00729 KS
Professional Counselor 101YP2500X 2869 KS
Addiction (Substance Use Disorder) Counselor 101YA0400X 17916 TX Primary

Addresses

Primary practice location

3205 Clinton Parkway CT
Lawrence, KS 66047-2627

Mailing address

3205 Clinton Parkway CT
Lawrence, KS 66047-2627
Phone (785) 843-5483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
00729KSMDAddiction (Substance Use Disorder) Counselor
17916TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Treatment Services, LLC Addiction (Substance Use Disorder) CurrentSince Dec 13, 2020 Accepting new patients
Denton County MHMR Center Past Accepting new patients
Professional Treatment Services PastSince Dec 13, 2020 Accepting new patients

Locations

3205 Clinton Parkway Ct
Lawrence, KS 66047
Phone (785) 843-5483

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1414713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1699170738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 CLINTON PARKWAY CT",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660472627",
            "telephone_number": "785-843-5483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 CLINTON PARKWAY CT",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660472627",
            "telephone_number": "785-843-5483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERA",
        "first_name": "RYAN",
        "credential": "LCAC, LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-31",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "00729",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KS",
            "license": "2869",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "17916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, KS

Sources for this page

Verify at the official NPI Registry.