CMS-1500 Box 24J / 33a • NPI
1053665315
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
101YA0400X
Licensed & Credentialed Counselor, Addiction (Substance Use Disorder)
Box 32 Service Location & ZIP+4
204 W HIGHLAND AVE, ROBINSON, IL, 62454-1710
✓ 9-Digit EDI 837 ZIP+4 (62454-1710)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1053665315 (RYAN FLETCHER, MS) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1053665315 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | RYAN FLETCHER, MS |
| Plain-English Specialty | Licensed & Credentialed Counselor, Addiction (Substance Use Disorder) NUCC Code: 101YA0400X (Counselor, Addiction (Substance Use Disorder)) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 204 W HIGHLAND AVE, ROBINSON, IL, 62454-1710 |
| Practice Telephone / Fax | Tel: (618) 546-5232 | Fax: (618) 546-5657 |
| Administrative Mailing Address | 504 MICAH DR, OLNEY, IL, 62450-4720 |
| Enumeration & Last Sync | Enumerated: 2012-11-07 | CMS Record Updated: 2012-11-07 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (101YA0400X)
What Does Taxonomy Code 101YA0400X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 101YA0400X translates to:
"Licensed & Credentialed Counselor, Addiction (Substance Use Disorder)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (RYAN FLETCHER, MS)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
101Y00000X — CounselorPlain English: Licensed & Credentialed Counselor | State: N/A | License: Verified | Primary: Secondary |
101YA0400X — Counselor, Addiction (Substance Use Disorder)Plain English: Licensed & Credentialed Counselor, Addiction (Substance Use Disorder) | State: N/A | License: Verified | Primary: Yes (Primary) |
101YM0800X — Counselor, Mental HealthPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor | State: N/A | License: Verified | Primary: Secondary |
Medical Billing, RCM & Hospital Credentialing Teams:
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