Provider Demographics
NPI:1437330842
Name:VAN RYN, CYNTHIA RAE (MSED, LPC)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:RAE
Last Name:VAN RYN
Suffix:
Gender:F
Credentials:MSED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 WILLOW RUN RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15717-4235
Mailing Address - Country:US
Mailing Address - Phone:814-534-6138
Mailing Address - Fax:
Practice Address - Street 1:608 WILLOW RUN RD
Practice Address - Street 2:SUITE 1
Practice Address - City:BLAIRSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15717-4235
Practice Address - Country:US
Practice Address - Phone:814-534-6138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
PALPC137101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)