Provider Demographics
NPI:1477711950
Name:ESPENSCHIED, RYAN N (MA, LPC)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:N
Last Name:ESPENSCHIED
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 PERUQUE CROSSING CT
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-2362
Mailing Address - Country:US
Mailing Address - Phone:636-887-3655
Mailing Address - Fax:636-887-3655
Practice Address - Street 1:1031 PERUQUE CROSSING CT
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-2362
Practice Address - Country:US
Practice Address - Phone:636-887-3655
Practice Address - Fax:636-887-3655
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-30
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003032186101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional