Provider Demographics
NPI:1821759721
Name:DELANEY, RYAN EUGENE (LGPC)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:EUGENE
Last Name:DELANEY
Suffix:
Gender:M
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:HAVRE DE GRACE
Mailing Address - State:MD
Mailing Address - Zip Code:21078-3521
Mailing Address - Country:US
Mailing Address - Phone:336-707-2821
Mailing Address - Fax:
Practice Address - Street 1:3000 CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-2727
Practice Address - Country:US
Practice Address - Phone:376-707-2821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP10632101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health