Provider Demographics
NPI:1922575604
Name:RYAN, CYNTHIA (LMHC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:RYAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 HAYWARD MILL RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-3919
Mailing Address - Country:US
Mailing Address - Phone:617-319-9763
Mailing Address - Fax:
Practice Address - Street 1:127 HAYWARD MILL RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-3919
Practice Address - Country:US
Practice Address - Phone:617-319-9763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-31
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13404101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA273058664OtherSTATE OF MASSACHUSETTS