Provider Demographics
NPI:1144763889
Name:MOORE, RYAN (LPCC-S)
Entity Type:Individual
Prefix:MRS
First Name:RYAN
Middle Name:
Last Name:MOORE
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2416 NEWTON ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44305-3932
Mailing Address - Country:US
Mailing Address - Phone:330-814-2231
Mailing Address - Fax:
Practice Address - Street 1:2795 FRONT ST STE A
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-1900
Practice Address - Country:US
Practice Address - Phone:234-206-0562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-29
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1800878-SUPV101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health