Provider Demographics
NPI:1356708705
Name:JOUETT, RYAN
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:JOUETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 N SCOTTSDALE RD STE 2500
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-7630
Mailing Address - Country:US
Mailing Address - Phone:216-468-5000
Mailing Address - Fax:
Practice Address - Street 1:2458 OLD DORSETT RD STE 110
Practice Address - Street 2:
Practice Address - City:MARYLAND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63043-2423
Practice Address - Country:US
Practice Address - Phone:636-939-2550
Practice Address - Fax:636-939-2551
Is Sole Proprietor?:No
Enumeration Date:2016-01-15
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MO2024049053101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor