Individual
RYAN SERSHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
W175N11081 STONEWOOD DR STE 212, GERMANTOWN, WI 53022-4771
(262) 244-6177
Mailing address
1035 W GLEN OAKS LN STE 110, MEQUON, WI 53092-3392
(262) 244-6178
(262) 299-3040
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15925
WI
1041C0700X
Clinical Social Worker
Primary
8525
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000677057
—
WI
01
—
8525-123
LCSW
WI
Enumeration date
03/16/2017
Last updated
08/25/2021
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