Provider Demographics
NPI:1134714611
Name:URZEN, RYAN (LMHC)
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:
Last Name:URZEN
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4038
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-4038
Mailing Address - Country:US
Mailing Address - Phone:561-570-4810
Mailing Address - Fax:
Practice Address - Street 1:100 S MILITARY TRAIL
Practice Address - Street 2:STE 13 #4038
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442
Practice Address - Country:US
Practice Address - Phone:561-570-4810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-05
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH18942101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health