Basic Information
Provider Information
NPI: 1598134504
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FOLMSBEE
FirstName: RYAN
MiddleName: RYU
NamePrefix: MR.
NameSuffix:  
Credential: T-LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7575 W 106TH ST
Address2: APT. 420
City: OVERLAND PARK
State: KS
PostalCode: 662125920
CountryCode: US
TelephoneNumber: 7852215799
FaxNumber:  
Practice Location
Address1: 10550 MARTY ST
Address2: SUITE 102
City: OVERLAND PARK
State: KS
PostalCode: 662122557
CountryCode: US
TelephoneNumber: 9139526696
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/20/2015
LastUpdateDate: 09/20/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X2835KSY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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