Provider Demographics
NPI:1598830192
Name:NEUMAN, RYANNE L (LMSW)
Entity Type:Individual
Prefix:MS
First Name:RYANNE
Middle Name:L
Last Name:NEUMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:RYANNE
Other - Middle Name:L
Other - Last Name:MEINEMA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:201 SHELDON BLVD SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-4513
Mailing Address - Country:US
Mailing Address - Phone:616-459-4212
Mailing Address - Fax:616-774-9022
Practice Address - Street 1:201 SHELDON BLVD SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-4513
Practice Address - Country:US
Practice Address - Phone:616-459-4212
Practice Address - Fax:616-774-9022
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801088169104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0D16159Medicare ID - Type UnspecifiedGROUP NUMBER TOUCHSTONE