Provider Demographics
NPI:1508034786
Name:MOREHEAD, RYAN MCNEALY (MED, LPC-MSHP)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:MCNEALY
Last Name:MOREHEAD
Suffix:
Gender:F
Credentials:MED, LPC-MSHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:SIGNAL MOUNTAIN
Mailing Address - State:TN
Mailing Address - Zip Code:37377-3350
Mailing Address - Country:US
Mailing Address - Phone:864-200-1729
Mailing Address - Fax:
Practice Address - Street 1:3085 BROAD ST STE I
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37408-3089
Practice Address - Country:US
Practice Address - Phone:864-200-1729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3846101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional