Active NPI
Robert Kevin Ryan
- Mental Health Counselor
- Agoura Hills, CA
National Provider Identifier
1760851224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MFT85893
- Practice address
- 28310 Roadside Drive Suite 235
Agoura Hills, CA 91301 - Phone
- (310) 924-0273
- NPI assigned
- Sep 15, 2015
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MFT85893 | CA | Primary |
Addresses
Primary practice location
28310 Roadside Drive Suite 235
Agoura Hills, CA 91301
Mailing address
PO Box 6041
Malibu, CA 90264-6041
Phone (310) 924-0273
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFT85893 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442275200000",
"number": "1760851224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6041",
"city": "MALIBU",
"state": "CA",
"postal_code": "902646041",
"telephone_number": "310-924-0273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28310 ROADSIDE DRIVE SUITE 235",
"city": "AGOURA HILLS",
"state": "CA",
"postal_code": "91301",
"telephone_number": "310-924-0273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "ROBERT",
"middle_name": "KEVIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-09-15",
"last_updated": "2015-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "MFT85893",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Agoura Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.