Provider Demographics
NPI:1295956845
Name:RYAN, MEGAN (MS, CRC, LCPC)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:
Last Name:RYAN
Suffix:
Gender:F
Credentials:MS, CRC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1283 ANGELINE DR.
Mailing Address - Street 2:
Mailing Address - City:SOUTH ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60177
Mailing Address - Country:US
Mailing Address - Phone:847-514-2397
Mailing Address - Fax:312-528-9199
Practice Address - Street 1:1283 ANGELINE DR.
Practice Address - Street 2:
Practice Address - City:SOUTH ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60177
Practice Address - Country:US
Practice Address - Phone:847-514-2397
Practice Address - Fax:312-528-9199
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.006466101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional