Provider Demographics
NPI:1063974558
Name:RYAN, PETER JOSEPH (LPC)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:JOSEPH
Last Name:RYAN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 W OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-4214
Mailing Address - Country:US
Mailing Address - Phone:610-297-1175
Mailing Address - Fax:
Practice Address - Street 1:70 W OAKLAND AVE STE 103
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-4214
Practice Address - Country:US
Practice Address - Phone:610-297-1175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-03
Last Update Date:2023-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor