| Ryan Macks, Llc | |
|
7577 Central Parke Blvd Suite 113 Mason OH 45040-6810 | |
| (513) 204-5746 | |
| (513) 229-3707 |
| Full Name | Ryan Macks, Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 7577 Central Parke Blvd, Mason, Ohio |
| Authorized Official Name and Position | Ryan Macks (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 5132045746 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ryan Macks, Llc 7577 Central Parke Blvd Suite 113 Mason OH 45040-6810 Ph: (513) 204-5746 | Ryan Macks, Llc 7577 Central Parke Blvd Suite 113 Mason OH 45040-6810 Ph: (513) 204-5746 |
| NPI Number | 1548501059 |
|---|---|
| Provider Enumeration Date | 03/07/2013 |
| Last Update Date | 05/17/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548501059 | NPI | - | NPPES |
| MACP79161 | Other | OH | MEDICARE |
| 2592725 | Medicaid | OH | |
| 0080731 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6162 (Ohio) | Primary |
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