Healthcare Provider Details

I. General information

NPI: 1871442335
Provider Name (Legal Business Name): LAUREN PETZ LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 N 9TH ST
GARDEN CITY KS
67846-2910
US

IV. Provider business mailing address

2010 N 9TH ST
GARDEN CITY KS
67846-2910
US

V. Phone/Fax

Practice location:
  • Phone: 620-566-7447
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number05292
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: