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Individual
NOLAN RYAN FELLOWS
Active
Individual
NOLAN RYAN FELLOWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CST, LCPC, LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LCPC-9689
ID
101YM0800X
Mental Health Counselor
Primary
LPC.0023097
CO
101YP2500X
Professional Counselor
Primary
LPC-7740
ID
Other
Enumeration date
06/25/2020
Last updated
04/27/2026
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