Provider Demographics
NPI:1356669329
Name:OZIAS, RYAN RUSSELL (LCMFT, LCPC)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:RUSSELL
Last Name:OZIAS
Suffix:
Gender:M
Credentials:LCMFT, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5809 N SPRUCE AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64119-2867
Mailing Address - Country:US
Mailing Address - Phone:785-430-1666
Mailing Address - Fax:
Practice Address - Street 1:2000 SW GAGE BLVD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-3340
Practice Address - Country:US
Practice Address - Phone:785-272-0778
Practice Address - Fax:785-272-2056
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-14
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2145101YP2500X
KS2360106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200642690BMedicaid