Provider Demographics
NPI:1518202415
Name:WILLIAMS, RYAN (MA, BCBA, LBA)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 W 32ND ST
Mailing Address - Street 2:8TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-3212
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5205 KERLEY LN
Practice Address - Street 2:
Practice Address - City:SACHSE
Practice Address - State:TX
Practice Address - Zip Code:75048-4751
Practice Address - Country:US
Practice Address - Phone:917-939-5104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-03
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-08-4577103K00000X
TX2428103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst