Powell, Ryland Bouldin

Powell, Ryland Bouldin is an sole proprietor health care provider with primary practice located at 74 Parker Ave , Maplewood NJ 07040-1746. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Powell, Ryland Bouldin can be contacted via phone (973) 763-2155.

Contact Information

Primary practice address
74 Parker Ave Maplewood NJ 07040-1746
Phone: (973) 763-2155
Fax: (973) 763-6225
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 44SC00017300 New Jersey
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 37F100055500 New Jersey

Profile Details

NPI number 1760520860
LBN Legal business name Powell, Ryland Bouldin
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 1st, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760520860 NPPES
Other 11234975 CIGNA BEHAV.HEALTH

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