Provider Demographics
NPI:1437112711
Name:RYAN, MELANIE (LCSWR)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:RYAN
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 E MAIN ST STE F2
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-2317
Mailing Address - Country:US
Mailing Address - Phone:914-260-1696
Mailing Address - Fax:914-941-2085
Practice Address - Street 1:153 E MAIN ST STE F2
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-2317
Practice Address - Country:US
Practice Address - Phone:914-260-1696
Practice Address - Fax:914-941-2085
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-08
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker