Provider Demographics
NPI:1679246037
Name:ROPP, RYAN A (LCSW)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:A
Last Name:ROPP
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2460 SUNNY MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72404-9302
Mailing Address - Country:US
Mailing Address - Phone:870-935-5134
Mailing Address - Fax:
Practice Address - Street 1:2460 SUNNY MEADOW DR
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72404-9302
Practice Address - Country:US
Practice Address - Phone:870-935-5134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR9059-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical