Provider Demographics
NPI:1841010907
Name:OSTRANDER, TERRANCE LEE (MA, LPCC)
Entity type:Individual
Prefix:
First Name:TERRANCE
Middle Name:LEE
Last Name:OSTRANDER
Suffix:
Gender:M
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2078 RICHARD AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55110-4728
Mailing Address - Country:US
Mailing Address - Phone:612-203-5099
Mailing Address - Fax:
Practice Address - Street 1:1114 GRAND AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-2628
Practice Address - Country:US
Practice Address - Phone:612-284-1848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC04578101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health