Provider Demographics
NPI:1922680313
Name:RYNN, AMY (LCPC, ATR-BC, LPC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:RYNN
Suffix:
Gender:F
Credentials:LCPC, ATR-BC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 W WASHINGTON ST STE B
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-4031
Mailing Address - Country:US
Mailing Address - Phone:906-256-2951
Mailing Address - Fax:
Practice Address - Street 1:1025 W WASHINGTON ST STE B
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-4031
Practice Address - Country:US
Practice Address - Phone:906-256-2951
Practice Address - Fax:906-629-6334
Is Sole Proprietor?:No
Enumeration Date:2021-04-25
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.011896101Y00000X, 101YP2500X
MI6401222979101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor