Provider Demographics
NPI:1386370831
Name:ELIZABETH RYAN, LCSW, P.C.
Entity type:Organization
Organization Name:ELIZABETH RYAN, LCSW, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:B
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:719-659-5194
Mailing Address - Street 1:6292 TURRET DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-3219
Mailing Address - Country:US
Mailing Address - Phone:719-659-5194
Mailing Address - Fax:
Practice Address - Street 1:6292 TURRET DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-3219
Practice Address - Country:US
Practice Address - Phone:719-659-5194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-27
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)