Marisa Lee Ryan, MHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

P105928 Issued in NY

Practice address

1915 Forest Ave
Staten Island, NY 10303-2127

Phone

(718) 981-3136

NPI assigned

Mar 1, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1821682931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 FOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103032127",
            "telephone_number": "718-981-3136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 FOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103032127",
            "telephone_number": "718-981-3136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "MARISA",
        "middle_name": "LEE",
        "credential": "MHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P105928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "marisa.ryan@samaritanvillage.org",
            "affiliation": "N",
            "endpointDescription": "Email address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1915 Forest Ave",
            "city": "Staten Island",
            "state": "NY",
            "country_code": "US",
            "postal_code": "103032127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anna Ryaboy, PT
• Alyssa Elizabeth Ryan, LCSW
• Eileen Marie Ryan, M.A., CCC/SLP
• Erin J Ryan, PH.D.
• Kathryn Marie Ryan, LMSW
• Maureen Ryan, LMSW
• Michael Ryan, CASAC-T
• Michelle Liora Rybak, DDS
• Lauren Rybarczyk, RN
• Carissa Elizabeth Rychalski

• Mental Health Counselor in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; 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.