Stivers, Ryan Joseph

Stivers, Ryan Joseph is an individual health care provider with primary practice located at 1717 W Candletree Dr Ste. B, Peoria IL 61614-1592. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Marriage & Family Therapist is his primary health care specialty. Stivers, Ryan Joseph can be contacted via phone (309) 713-1485.

Contact Information

Primary practice address
1717 W Candletree Dr Ste. B Peoria IL 61614-1592
Phone: (309) 713-1485
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X P1111086 Arkansas
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X M1206007 Arkansas
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 166001032 Illinois

Profile Details

NPI number 1316268113
LBN Legal business name Stivers, Ryan Joseph
Credentials PH.D., LMFT, LPC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2010
Last updated Nov 1st, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316268113 NPPES
Arkansas MEDICAID 182287795

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