Individual
LAUREN FORTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LADC, LPCC
Contact information
Practice address
13100 WAYZATA BLVD STE 200, MINNETONKA, MN 55305-1810
(952) 206-2040
(952) 206-2041
Mailing address
1900 SILVER LAKE RD NW, SUITE 110, NEW BRIGHTON, MN 55112-1786
(651) 243-1566
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
304231
MN
101YP2500X
Professional Counselor
Primary
1934
MN
Other
Enumeration date
09/18/2015
Last updated
04/01/2024
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