Provider Demographics
NPI:1730601832
Name:MUFFI, RYAN (MA, LCPC)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:MUFFI
Suffix:
Gender:M
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5340 THUNDER HILL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-1914
Mailing Address - Country:US
Mailing Address - Phone:301-639-5375
Mailing Address - Fax:
Practice Address - Street 1:5340 THUNDER HILL RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-1914
Practice Address - Country:US
Practice Address - Phone:301-639-5375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-10
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC9629101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD43635OtherHUMANA
MD887323200Medicaid
MD6235936OtherAETNA
MDAX26-0058OtherBLUE CROSS BLUE SHIELD