1962049734 NPI number — DOWN TO EARTH PROFESSIONAL COUNSELING

Table of content: DR. RYAN CHRISTOPHER MERRITT MD (NPI 1578209185)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962049734 NPI number — DOWN TO EARTH PROFESSIONAL COUNSELING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DOWN TO EARTH PROFESSIONAL COUNSELING
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

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 Information

NPI Number:
1962049734
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/06/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
107 BURKESVILLE ST STE B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42728-1467
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-380-1810
Provider Business Mailing Address Fax Number:
270-380-1811

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
107 BURKESVILLE ST STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42728-1467
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-380-1810
Provider Business Practice Location Address Fax Number:
270-380-1811
Provider Enumeration Date:
11/29/2019

Additional Information

Authorized Official

Authorized Official Last Name:
ELLIS
Authorized Official First Name:
ALICE
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/PROVIDER
Authorized Official Telephone Number:
270-380-1810

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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