Individual
RYAN HENAGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC
Contact information
Practice address
400 W MAIN ST, RIVERHEAD, NY 11901-2813
(631) 369-0104
Mailing address
7 BROADWAY, SHIRLEY, NY 11967-2501
(631) 612-4988
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
32549
NY
Other
Enumeration date
02/19/2021
Last updated
02/19/2021
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