Provider Demographics
NPI:1295847952
Name:CIZEK-VOGEN, ERICA LYNN (MS LMFT)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:LYNN
Last Name:CIZEK-VOGEN
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W PINE ST
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082
Mailing Address - Country:US
Mailing Address - Phone:651-439-8800
Mailing Address - Fax:651-439-1040
Practice Address - Street 1:1976 WOODDALE DR
Practice Address - Street 2:STE #4
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125
Practice Address - Country:US
Practice Address - Phone:651-735-9534
Practice Address - Fax:651-735-8986
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLMFT1587106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNHP64443OtherHEALTH PARTNERS