Provider Demographics
NPI:1891736211
Name:RYAN, TRESSA RENEE (MSW, LICSW)
Entity type:Individual
Prefix:MS
First Name:TRESSA
Middle Name:RENEE
Last Name:RYAN
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 DEER HILL RD
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:NH
Mailing Address - Zip Code:03833-6600
Mailing Address - Country:US
Mailing Address - Phone:603-964-1700
Mailing Address - Fax:
Practice Address - Street 1:680 CENTRAL AVE STE 103
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-3495
Practice Address - Country:US
Practice Address - Phone:603-964-1700
Practice Address - Fax:603-749-7502
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1269061041C0700X
NHNH8191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH6555415OtherBCBS NH