Provider Demographics
NPI:1194242362
Name:LEDET, RYAN JAMES (LMSW)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:JAMES
Last Name:LEDET
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:RYAN
Other - Middle Name:JAMES
Other - Last Name:WANDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:826 1/2 MASSACHUSETTS ST STE 207
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-2639
Mailing Address - Country:US
Mailing Address - Phone:785-264-6204
Mailing Address - Fax:
Practice Address - Street 1:826 1/2 MASSACHUSETTS ST STE 207
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-2639
Practice Address - Country:US
Practice Address - Phone:785-264-6204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS10530104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker