Provider Demographics
NPI:1538968797
Name:BRENNY, LAUREN GRACE (MS, LPC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:GRACE
Last Name:BRENNY
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10900 89TH AVE N STE 2
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-4098
Mailing Address - Country:US
Mailing Address - Phone:763-200-1071
Mailing Address - Fax:833-611-0551
Practice Address - Street 1:10900 89TH AVE N STE 2
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-4098
Practice Address - Country:US
Practice Address - Phone:763-200-1071
Practice Address - Fax:833-611-0551
Is Sole Proprietor?:No
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3006101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health