Provider Demographics
NPI:1396492344
Name:DREWIANKA, RYAN (LPCC)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:DREWIANKA
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4141 OLD SIBLEY MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-1996
Mailing Address - Country:US
Mailing Address - Phone:612-217-0650
Mailing Address - Fax:
Practice Address - Street 1:4141 OLD SIBLEY MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-1996
Practice Address - Country:US
Practice Address - Phone:612-217-0650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-08
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4267101YP2500X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional