Provider Demographics
NPI:1699793398
Name:RYAN, ERIN KATHLEEN (LPC)
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:KATHLEEN
Last Name:RYAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 JUNIPER LN
Mailing Address - Street 2:
Mailing Address - City:GUNNISON
Mailing Address - State:CO
Mailing Address - Zip Code:81230-3801
Mailing Address - Country:US
Mailing Address - Phone:970-209-7707
Mailing Address - Fax:
Practice Address - Street 1:114 N BOULEVARD ST STE 203
Practice Address - Street 2:
Practice Address - City:GUNNISON
Practice Address - State:CO
Practice Address - Zip Code:81230-3011
Practice Address - Country:US
Practice Address - Phone:709-209-7707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3467101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional