Provider Demographics
NPI:1962106054
Name:LINDENMUTH, RYAN M
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:M
Last Name:LINDENMUTH
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 1:516 DRAYTON ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401-5651
Mailing Address - Country:US
Mailing Address - Phone:570-436-4045
Mailing Address - Fax:
Practice Address - Street 1:516 DRAYTON ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-5651
Practice Address - Country:US
Practice Address - Phone:570-436-4045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-30
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC008639101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health