Provider Demographics
NPI:1568168151
Name:RYBACKI, SHAWN (LPC)
Entity type:Individual
Prefix:MS
First Name:SHAWN
Middle Name:
Last Name:RYBACKI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 S 4TH ST STE 240E
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-1573
Mailing Address - Country:US
Mailing Address - Phone:267-474-4405
Mailing Address - Fax:
Practice Address - Street 1:525 S 4TH ST STE 240E
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-1573
Practice Address - Country:US
Practice Address - Phone:215-995-5058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0021235101YM0800X
PAPC017081101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health