Healthcare Provider Details

I. General information

NPI: 1093265274
Provider Name (Legal Business Name): LAUREN FINZER RYAN LADC, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. LAUREN ELIZABETH FINZER

II. Dates (important events)

Enumeration Date: 10/11/2016
Last Update Date: 02/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2265 COMO AVE
SAINT PAUL MN
55108-1737
US

IV. Provider business mailing address

881 WAGON WHEEL TRL
MENDOTA HEIGHTS MN
55120-1333
US

V. Phone/Fax

Practice location:
  • Phone: 651-645-5323
  • Fax:
Mailing address:
  • Phone: 651-728-2770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number304053
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCC01288
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: