Provider Demographics
NPI:1871641357
Name:RYDER, SCOTT F (MA, LPC, CFT)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:F
Last Name:RYDER
Suffix:
Gender:M
Credentials:MA, LPC, CFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9283 GALWAY RD
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-1665
Mailing Address - Country:US
Mailing Address - Phone:303-875-4998
Mailing Address - Fax:
Practice Address - Street 1:3100 BUCKNELL CT
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-3465
Practice Address - Country:US
Practice Address - Phone:303-499-1121
Practice Address - Fax:303-499-9332
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2299101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional