Provider Demographics
NPI:1083149058
Name:SHELLING, RYAN (LCSW)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:SHELLING
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 1:4480 GENERAL DEGAULLE DR
Mailing Address - Street 2:SUITE 219
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70131-6941
Mailing Address - Country:US
Mailing Address - Phone:504-564-1290
Mailing Address - Fax:504-564-1249
Practice Address - Street 1:4480 GENERAL DEGAULLE DR
Practice Address - Street 2:SUITE 219
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70131-6941
Practice Address - Country:US
Practice Address - Phone:504-564-1290
Practice Address - Fax:504-564-1249
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-26
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
LA148491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health