Doctor Name: | RYAN LANSDELL |
NPI Number: | 1063791812 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCADC |
License Number: | 37LC00175900 |
Business Practice Address: | 1001 Route 517, Suite #1 Hackettstown, NJ - 078403309 |
Business Phone Number: | 2018410777 |
Business Fax Number: | 9086848080 |
Mailing Address: | 1001 Route 517, Suite #1, HACKETTSTOWN |
State: | NJ |
Postal Code: | 078403309 |
Phone Number: | 2018410777 |
Fax Number: | 9086848080 |
NPI Enumeration Date: | 08/10/2011 |
NPI Last Update Date: | 04/01/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 37LC00175900 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |