Active NPI
Chad Ryan, MASTERS
- Professional Counselor
- Randolph, MA
National Provider Identifier
1891822615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 41 Pacella Park Dr
Randolph, MA 02368-1755 - Phone
- (781) 437-1323
- NPI assigned
- Feb 28, 2007
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Primary |
Addresses
Primary practice location
41 Pacella Park Dr
Randolph, MA 02368-1755
Mailing address
195 Plymouth St
Holbrook, MA 02343-1583
Phone (781) 437-1323
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 685661 | Other | MA | TUFTS |
| 1312677 | Medicaid | MA | |
| M18708 | Other | MA | BLUE CROSS |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891822615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "195 PLYMOUTH ST",
"city": "HOLBROOK",
"state": "MA",
"postal_code": "023431583",
"telephone_number": "781-437-1323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41 PACELLA PARK DR",
"city": "RANDOLPH",
"state": "MA",
"postal_code": "023681755",
"telephone_number": "781-437-1323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "CHAD",
"credential": "MASTERS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "685661",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1312677",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "M18708",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Randolph, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.