Provider Demographics
NPI:1972147346
Name:WINTERS, RYAN (MS, LPC)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:WINTERS
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 HUGH WALLIS RD S BLDG E
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-2528
Mailing Address - Country:US
Mailing Address - Phone:337-534-8140
Mailing Address - Fax:337-534-8141
Practice Address - Street 1:1003 HUGH WALLIS RD S BLDG E
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-2528
Practice Address - Country:US
Practice Address - Phone:337-534-8140
Practice Address - Fax:337-534-8141
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-29
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALPC6027101YM0800X
LAPLC6027101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health