Individual provider · Type 1 NPI

Ryan O. Theisen, LADC, LPCC

Mental Health Counselor · Plymouth, MN

NPI number 1376434597 Active

Practice location

2950 Xenium Ln N Ste 130
Plymouth, MN 55441-2623

Call (612) 564-3535 Map

Fax (763) 545-8150

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X306571 (MN)
Mental Health Counselor Primary 101YM0800X5099 (MN)

Mental Health Counselor: Definition to come...

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About NPI 1376434597

Ryan O. Theisen, LADC, LPCC's National Provider Identifier is 1376434597, issued on Jul 15, 2025. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Plymouth, MN. The record was last updated on Jul 15, 2025.