Provider Demographics
NPI:1376011502
Name:PATRICIA RYAN-JOHNSON, LCSW PLLC
Entity Type:Organization
Organization Name:PATRICIA RYAN-JOHNSON, LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:RYAN-JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:516-341-7161
Mailing Address - Street 1:224 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:MALVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11565-1215
Mailing Address - Country:US
Mailing Address - Phone:516-341-7161
Mailing Address - Fax:
Practice Address - Street 1:224 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:MALVERNE
Practice Address - State:NY
Practice Address - Zip Code:11565-1215
Practice Address - Country:US
Practice Address - Phone:516-341-7161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty