Provider Demographics
NPI:1700121860
Name:MCCANN, DAVID RYAN (LIMHP)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:RYAN
Last Name:MCCANN
Suffix:
Gender:M
Credentials:LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9509 S 171ST AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68136-1332
Mailing Address - Country:US
Mailing Address - Phone:402-651-9948
Mailing Address - Fax:
Practice Address - Street 1:9509 S 171ST AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68136-1332
Practice Address - Country:US
Practice Address - Phone:402-651-9948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2756101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health