Provider Demographics
NPI:1083112478
Name:WARE, RYAN MATTHEW (LCSW)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:MATTHEW
Last Name:WARE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43201-2460
Mailing Address - Country:US
Mailing Address - Phone:614-299-6600
Mailing Address - Fax:614-227-6873
Practice Address - Street 1:1090 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-9116
Practice Address - Country:US
Practice Address - Phone:941-363-0878
Practice Address - Fax:716-242-3360
Is Sole Proprietor?:No
Enumeration Date:2018-01-31
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.19018401041C0700X
FLSW207341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical