Provider Demographics
NPI:1972088110
Name:PRICE, RYAN STUART (MA, LPC)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:STUART
Last Name:PRICE
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 W ANTLER AVE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-1852
Mailing Address - Country:US
Mailing Address - Phone:541-241-2105
Mailing Address - Fax:458-256-6551
Practice Address - Street 1:128 W ANTLER AVE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-1852
Practice Address - Country:US
Practice Address - Phone:541-241-2105
Practice Address - Fax:458-256-6551
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-03
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-23107101YM0800X
ORC6051101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health