Provider Demographics
NPI:1407893498
Name:VRANEY, MARY (PHD, LP, LMFT)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:VRANEY
Suffix:
Gender:F
Credentials:PHD, LP, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 DECATUR AVE. N
Mailing Address - Street 2:109
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55427-3040
Mailing Address - Country:US
Mailing Address - Phone:763-746-2400
Mailing Address - Fax:763-746-2401
Practice Address - Street 1:701 DECATUR AVE N
Practice Address - Street 2:109
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55427-4367
Practice Address - Country:US
Practice Address - Phone:763-746-2400
Practice Address - Fax:763-746-2401
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP1378103T00000X
MN746106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN680001896Medicare ID - Type Unspecified