Provider Demographics
NPI:1548892649
Name:RYAN LEYBAS PLLC
Entity type:Organization
Organization Name:RYAN LEYBAS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEYBAS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:801-277-2129
Mailing Address - Street 1:1174 E GRAYSTONE WAY STE 6
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84106-2671
Mailing Address - Country:US
Mailing Address - Phone:801-277-2129
Mailing Address - Fax:801-713-1431
Practice Address - Street 1:1174 E GRAYSTONE WAY STE 6
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-2671
Practice Address - Country:US
Practice Address - Phone:801-277-2129
Practice Address - Fax:801-713-1431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty