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Individual

JAMES M RYAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCPC LCADC CRC CDMS

Contact information

Practice address
19630 CLUB HOUSE RD STE 715, MONTGOMERY VILLAGE, MD 20886
(301) 258-7771
(301) 258-9078
Mailing address
19630 CLUB HOUSE RD STE 715, MONTGOMERY VILLAGE, MD 20886-3040
(301) 258-7771
(301) 258-9078

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LCA372
MD STATE LINCENSE
MD
Enumeration date
04/24/2008
Last updated
08/23/2018
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