Provider Demographics
NPI:1952758245
Name:PARKS, RYAN (LPCC)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:PARKS
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3763 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3547
Mailing Address - Country:US
Mailing Address - Phone:614-450-2390
Mailing Address - Fax:866-594-7023
Practice Address - Street 1:3763 N HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3547
Practice Address - Country:US
Practice Address - Phone:614-450-2390
Practice Address - Fax:866-594-7023
Is Sole Proprietor?:No
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1300381101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health