Provider Demographics
NPI:1104412600
Name:ROMINGER, RYAN AUSTIN (PHD, LCPC)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:AUSTIN
Last Name:ROMINGER
Suffix:
Gender:M
Credentials:PHD, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1095
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59403-1095
Mailing Address - Country:US
Mailing Address - Phone:406-781-8260
Mailing Address - Fax:
Practice Address - Street 1:440 ROMINGER LN
Practice Address - Street 2:
Practice Address - City:FLOWEREE
Practice Address - State:MT
Practice Address - Zip Code:59440-9049
Practice Address - Country:US
Practice Address - Phone:406-734-5284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-18
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-46638101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health