Vivian Ryu LCSW PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

VIVIAN RYU LCSW PLLC

Practice address

2300 E Fry Blvd
Sierra Vista, AZ 85635-2712

Phone

(520) 559-4976

NPI assigned

Mar 27, 2020

Organization subpart

No

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

Authorized official

Name

Vivian Ryu, LCSWNPI 1700397411

Title

Therapist

Phone

(520) 220-6009

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vivian Ryu, LCSW

  • Clinical Social Worker
  • Sierra Vista, AZ
  • NPI 1700397411
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585267200000",
    "number": "1962030833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3822",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856363822",
            "telephone_number": "520-220-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 E FRY BLVD",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352712",
            "telephone_number": "520-559-4976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVIAN RYU LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-27",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A",
        "authorized_official_last_name": "RYU",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "520-220-6009",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Sierra Vista, AZ
• Providers in Sierra Vista, AZ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.