NPIMap

Organization Active NPI

Ryan Rehabilitation LLC

  • Addiction (Substance Use Disorder) Counselor
  • Montgomery Village, MD
National Provider Identifier
1780164087
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
RYAN REHABILITATION LLC
Practice address
19630 Club House Rd Ste 715
Montgomery Village, MD 20886
Phone
(301) 258-7771
Fax
(301) 258-9078
NPI assigned
Aug 16, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Authorized official

Name
Melanie Suthard
Title
Billing Manager
Phone
(301) 942-9773

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X Primary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X

Addresses

Primary practice location

19630 Club House Rd Ste 715
Montgomery Village, MD 20886

Mailing address

19630 Club House Rd Ste 715
Montgomery Village, MD 20886-3040
Phone (301) 258-7771

Other identifiers 1

IdentifierTypeStateIssuer
654084800MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Ryan Rehabilitation LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1780164087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19630 CLUB HOUSE RD STE 715",
            "city": "MONTGOMERY VILLAGE",
            "state": "MD",
            "postal_code": "208863040",
            "telephone_number": "301-258-7771",
            "fax_number": "301-257-9078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19630 CLUB HOUSE RD STE 715",
            "city": "MONTGOMERY VILLAGE",
            "state": "MD",
            "postal_code": "20886",
            "telephone_number": "301-258-7771",
            "fax_number": "301-258-9078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-16",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "SUTHARD",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "301-942-9773"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "654084800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery Village, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.