Provider Demographics
NPI:1962760330
Name:SZTORCH, RYAN J (LCP, LLC)
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:J
Last Name:SZTORCH
Suffix:
Gender:M
Credentials:LCP, LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4940 MULLEN RD
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66216-1275
Mailing Address - Country:US
Mailing Address - Phone:913-406-4999
Mailing Address - Fax:
Practice Address - Street 1:708 W 9TH ST
Practice Address - Street 2:#106
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-2893
Practice Address - Country:US
Practice Address - Phone:785-371-6554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-24
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1435103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist