1649577222 NPI number — RYAN SMITH BA,CSMS,CNLP,CHHP

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649577222 NPI number — RYAN SMITH BA,CSMS,CNLP,CHHP

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

SMITH

Provider First Name:

RYAN

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

BA,CSMS,CNLP,CHHP

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1649577222

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

11/02/2012

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

461 COCHRAN RD

Provider Second Line Business Mailing Address:

#140

Provider Business Mailing Address City Name:

MT LEBANON

Provider Business Mailing Address State Name:

PA

Provider Business Mailing Address Postal Code:

15228-1253

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

412-969-2733

Provider Business Mailing Address Fax Number:

412-774-2069

Provider First Line Business Practice Location Address:

210 BOWER HILL RD

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

MT LEBANON

Provider Business Practice Location Address State Name:

PA

Provider Business Practice Location Address Postal Code:

15228-1419

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

412-760-4626

Provider Business Practice Location Address Fax Number:

412-774-2069

Provider Enumeration Date:

02/17/2011

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 101YA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 101YP1600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 133NN1002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 172V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 174H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 175F00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 246Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
• Taxonomy code: 225CA2400X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 225CA2400X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 225CA2400X , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 225CA2400X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 225CA2500X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

• Identifier: PA-2279(B) . This is a "COGNITIVE TRAINING SPECIALIST THROUGH UNIQUE LOGIC & TECHNOLOGY, INC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: PA-2279(B) . This is a "COGNITIVE TRAINING SPECIALIST THROUGH UNIQUE LOGIC & TECHNOLOGY, INC" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
• Identifier: 70393001 . This is a "BOARD CERTIFICATION AADP (AMERICAN ASSOCIATION OF DRUGLESS PRACTITIONERS)" identifier . This identifiers is of the category "OTHER".
• Identifier: DC0234 . This is a "BOARD CERTIFICATION- DISASTER CRISIS OUTREACH&REFERRAL PROF. (PA CERT. BOARD)" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: AL011937 . This is a "UNION CERTIFICATION BY HYPNOTHERAPISTS LOCAL NO. 472" identifier . This identifiers is of the category "OTHER".
• Identifier: PA-2279(B) . This is a "COGNITIVE TRAINING SPECIALIST THROUGH UNIQUE LOGIC & TECHNOLOGY, INC" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
• Identifier: PA-2279(B) . This is a "COGNITIVE TRAINING SPECIALIST THROUGH UNIQUE LOGIC & TECHNOLOGY, INC" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: PA-2279(B) . This is a "COGNITIVE TRAINING SPECIALIST THROUGH UNIQUE LOGIC & TECHNOLOGY, INC" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
• Identifier: NP-001070 . This is a "BOARD CERTIFICATION AIP (ASSOCIATION FOR INTEGRATIVE PSYCHOLOGY)" identifier . This identifiers is of the category "OTHER".