Individual provider Active NPI

Tressa Renee Ryan, MSW, LICSW

  • Clinical Social Worker
  • Dover, NH
National Provider Identifier
1891736211
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
NH819 Issued in NH
Practice address
680 Central Ave Ste 103
Dover, NH 03820-3495
Phone
(603) 964-1700
Fax
(603) 749-7502
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 126906 MA
Clinical Social Worker 1041C0700X NH819 NH Primary

Addresses

Primary practice location

680 Central Ave Ste 103
Dover, NH 03820-3495

Mailing address

165 Deer Hill Rd
Brentwood, NH 03833-6600
Phone (603) 964-1700

Other identifiers 1

IdentifierTypeStateIssuer
6555415OtherNHBCBS NH

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL CAREPATHS.COM Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051223000230 NH Practitioner - Clinical Social Worker 1456373067 Practice locations: Dover, NH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

680 Central Ave
Suite 103
Dover, NH 03820-3495
Phone (603) 964-1700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NH819NHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Counseling Center, PLLC Past Accepting new patients

Organizations & group practices 1

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1891736211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 DEER HILL RD",
            "city": "BRENTWOOD",
            "state": "NH",
            "postal_code": "038336600",
            "telephone_number": "603-964-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 CENTRAL AVE STE 103",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038203495",
            "telephone_number": "603-964-1700",
            "fax_number": "603-749-7502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "TRESSA",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "126906",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "NH819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NH",
            "identifier": "6555415",
            "state": "NH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "CAREPATHS.COM",
            "affiliation": "N",
            "endpointDescription": "Carepaths EHR Software",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "680 Central Ave Ste 103",
            "city": "Dover",
            "state": "NH",
            "country_code": "US",
            "postal_code": "038203495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

Verify at the official NPI Registry.