Provider Demographics
NPI:1750624763
Name:CHENEY, RYAN JAMES (MS, NCC, LPC)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:JAMES
Last Name:CHENEY
Suffix:
Gender:M
Credentials:MS, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 41
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97709-0041
Mailing Address - Country:US
Mailing Address - Phone:541-390-0017
Mailing Address - Fax:
Practice Address - Street 1:2863 NW CROSSING DR STE 217
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-7190
Practice Address - Country:US
Practice Address - Phone:541-241-6445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR101YM0800X
ORC3743101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health