# JAMES M RYAN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ryan Rehabilitation
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790102531
- **Authorized official:** MRS. TRACY ASBURY (BILLING MANAGER)
- **Authorized official phone:** (301) 942-9773

## Contact information

- **Practice address:** 19586 CLUB HOUSE RD, MONTGOMERY VILLAGE, MD 20886-3002
- **Practice address phone:** (301) 258-7771
- **Practice address fax:** (301) 258-9078
- **Mailing address:** 19586 CLUB HOUSE RD, MONTGOMERY VILLAGE, MD 20886-3002
- **Mailing address phone:** (301) 258-7771
- **Mailing address fax:** (301) 258-9078

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | LCA372 | MD | — |
| 101YM0800X | Mental Health Counselor | LC1361 | MD | Yes |

## Other

- **Enumeration date:** 03/18/2014
- **Last updated:** 03/18/2014