Provider Demographics
NPI:1538033725
Name:ADAMS, RYAN JOSEPH
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:JOSEPH
Last Name:ADAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 ELLA ST APT 122
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-4184
Mailing Address - Country:US
Mailing Address - Phone:985-255-1148
Mailing Address - Fax:
Practice Address - Street 1:1602 W PINHOOK RD STE 201
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3735
Practice Address - Country:US
Practice Address - Phone:337-534-0770
Practice Address - Fax:337-534-4370
Is Sole Proprietor?:No
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator