Lauren Renaye Lefavor Dickie, PSYD LP

Individual provider Active NPI Clinical Psychologist · Saint Peter, MN

NPI 1790716520 · NPPES record last updated Jul 2, 2018

Key facts

NPI
1790716520
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
LP3919 (MN)
Practice address
108 S Minnesota Ave
Saint Peter, MN 56082
Phone
(507) 934-3312
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
LP3919MNMDPsychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP3919 MN
Clinical Psychologist 103TC0700X LP3919 MN Yes

Addresses

Primary practice location

108 S Minnesota Ave
Saint Peter, MN 56082

Mailing address

108 S Minnesota Ave Ste 205
Saint Peter, MN 56082-2557
Phone (507) 721-1227

Other names

  • Dr. Lauren Lefavor Professional name

Other providers in Saint Peter, MN

All providers in Saint Peter, MN · Clinical Psychologist in Minnesota

Sources for this page

Verify at the official NPI Registry.