Provider Demographics
NPI:1700289477
Name:DILLON, RYAN (LPC)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:
Last Name:DILLON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1114 CAMINO LA COSTA APT 2014
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-3951
Mailing Address - Country:US
Mailing Address - Phone:512-593-2287
Mailing Address - Fax:
Practice Address - Street 1:1114 CAMINO LA COSTA APT 2014
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-3951
Practice Address - Country:US
Practice Address - Phone:512-593-2287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-08
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health