Provider Demographics
NPI:1891389441
Name:WALSH, RYAN N (MA, NCC, LAC, LCADC)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:N
Last Name:WALSH
Suffix:
Gender:M
Credentials:MA, NCC, LAC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 BLOSSOM DR
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-1768
Mailing Address - Country:US
Mailing Address - Phone:732-232-3599
Mailing Address - Fax:
Practice Address - Street 1:2224 WHITESVILLE RD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-1041
Practice Address - Country:US
Practice Address - Phone:848-221-3022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor