Provider Demographics
NPI:1083399026
Name:MUIR, RYAN (LPC)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:
Last Name:MUIR
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1470 SOUTHFIELD DR APT 3
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-5341
Mailing Address - Country:US
Mailing Address - Phone:630-930-1657
Mailing Address - Fax:
Practice Address - Street 1:2124 OGDEN AVE STE 301
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-7542
Practice Address - Country:US
Practice Address - Phone:630-441-6092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.019849101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health