Provider Demographics
NPI:1992849178
Name:TENOPIR, RYAN W (LIMHP, LMHP)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:W
Last Name:TENOPIR
Suffix:
Gender:M
Credentials:LIMHP, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8101 O ST
Mailing Address - Street 2:STE 101
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2646
Mailing Address - Country:US
Mailing Address - Phone:402-261-3714
Mailing Address - Fax:888-959-0716
Practice Address - Street 1:8101 O ST
Practice Address - Street 2:STE 101
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2646
Practice Address - Country:US
Practice Address - Phone:402-261-3714
Practice Address - Fax:888-959-0716
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3149101YM0800X
NE999101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025469500Medicaid