Provider Demographics
NPI:1619761269
Name:GREENWOOD, RYAN M (CPC)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:M
Last Name:GREENWOOD
Suffix:
Gender:M
Credentials:CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 PINION SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-4122
Mailing Address - Country:US
Mailing Address - Phone:804-381-3933
Mailing Address - Fax:
Practice Address - Street 1:2520 SAINT ROSE PKWY STE 214
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7789
Practice Address - Country:US
Practice Address - Phone:702-381-2192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCP5327101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health