Individual provider · Type 1 NPI

Ryan M. Ettner, LCSW-45249

Clinical Social Worker · Coeur D Alene, ID

NPI number 1356005367 Active

Practice location

1875 N Lakewood Dr
Coeur D Alene, ID 83814-4928

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X45249 (ID)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1356005367

Ryan M. Ettner, LCSW-45249's National Provider Identifier is 1356005367, issued on Oct 26, 2021. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Coeur D Alene, ID. The record was last updated on Dec 19, 2025.