Individual provider · Type 1 NPI

Jack Ryan, LADC, LPC

Professional Counselor · West Hartford, CT

NPI number 1922252246 Active

Practice location

2475 Albany Ave Ste 203B
West Hartford, CT 06117-2523

Call (860) 519-6492 Map

Fax (860) 519-6492

Mailing address

53 Manor Ln
South Windsor, CT 06074-3214

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X0008885 (CT)
Addiction (Substance Use Disorder) Counselor 101YA0400XNone listed
Professional Counselor Primary 101YP2500X003589 (CT)

Professional Counselor: Definition to come...

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About NPI 1922252246

Jack Ryan, LADC, LPC's National Provider Identifier is 1922252246, issued on Nov 13, 2008. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in West Hartford, CT. The record was last updated on Feb 8, 2019.