Provider Demographics
NPI:1932842697
Name:SADKIN, RYAN (LPC)
Entity Type:Individual
Prefix:MS
First Name:RYAN
Middle Name:
Last Name:SADKIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:RYAN
Other - Middle Name:SADKIN
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:5619 NORTHAVEN RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2937
Mailing Address - Country:US
Mailing Address - Phone:214-546-8133
Mailing Address - Fax:
Practice Address - Street 1:5619 NORTHAVEN RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2937
Practice Address - Country:US
Practice Address - Phone:214-546-8133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84462101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UNKNOWNOtherUNKNOWN