Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ryan Alan Petros, LICSW

Individual provider Clinical Social Worker · NPI 1821387093

Ryan Alan Petros, LICSW is a Clinical Social Worker in Minneapolis, Minnesota. Practices as a sole proprietor. Licensed in Minnesota.

Licensed in
MN
In the registry since
2011
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

2110 Lyndale Ave S
Minneapolis, MN 55405-3196
Phone: (612) 825-8714
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 18183 (MN)

Record details

NPI number1821387093
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorYes
NPI enumeratedMarch 28, 2011
Last updated in NPPESMarch 28, 2011

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