Provider Demographics
NPI:1215667530
Name:LANDAU, RYAN PAUL (LMHC)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:PAUL
Last Name:LANDAU
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10601 SW 116TH AVE UNIT 331
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-3143
Mailing Address - Country:US
Mailing Address - Phone:305-815-3546
Mailing Address - Fax:
Practice Address - Street 1:1951 NW 7TH AVE STE 600
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1128
Practice Address - Country:US
Practice Address - Phone:305-815-3546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH19448101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health