Provider Demographics
NPI:1801584420
Name:WELBORN, RYAN (LPC)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:WELBORN
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 1:3316 W 32ND AVE APT 201
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-3173
Mailing Address - Country:US
Mailing Address - Phone:802-851-7552
Mailing Address - Fax:
Practice Address - Street 1:3316 W 32ND AVE APT 201
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-3173
Practice Address - Country:US
Practice Address - Phone:802-851-7552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-01
Last Update Date:2025-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0020192101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty