Provider Demographics
NPI:1720774417
Name:RYSKEY, LAUREN IRENE (LLPC)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:IRENE
Last Name:RYSKEY
Suffix:
Gender:F
Credentials:LLPC
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 15
Mailing Address - Street 2:
Mailing Address - City:MARENISCO
Mailing Address - State:MI
Mailing Address - Zip Code:49947-0015
Mailing Address - Country:US
Mailing Address - Phone:906-392-0100
Mailing Address - Fax:
Practice Address - Street 1:N5241 US HIGHWAY 45
Practice Address - Street 2:
Practice Address - City:WATERSMEET
Practice Address - State:MI
Practice Address - Zip Code:49969-5115
Practice Address - Country:US
Practice Address - Phone:906-358-0252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-14
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451022923101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health