Provider Demographics
NPI:1063872729
Name:RYAN, BONNIE P (LISW-S)
Entity type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:P
Last Name:RYAN
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:BONNIE
Other - Middle Name:P
Other - Last Name:SCHWARTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW-S
Mailing Address - Street 1:455 E MOUND ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-5595
Mailing Address - Country:US
Mailing Address - Phone:614-242-1284
Mailing Address - Fax:614-242-1285
Practice Address - Street 1:455 E MOUND ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-5595
Practice Address - Country:US
Practice Address - Phone:614-242-1284
Practice Address - Fax:614-242-1285
Is Sole Proprietor?:No
Enumeration Date:2016-02-24
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1440363. SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical