Provider Demographics
NPI:1982451969
Name:ASADORIAN, RYAN MITCHELL (LMHC-A)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:MITCHELL
Last Name:ASADORIAN
Suffix:
Gender:M
Credentials:LMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 GRANT DR
Mailing Address - Street 2:
Mailing Address - City:COVENTRY
Mailing Address - State:RI
Mailing Address - Zip Code:02816-4304
Mailing Address - Country:US
Mailing Address - Phone:401-378-4097
Mailing Address - Fax:
Practice Address - Street 1:111 WAYLAND AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4371
Practice Address - Country:US
Practice Address - Phone:401-396-7649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00143-A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health