Healthcare Provider Details

I. General information

NPI: 1821910860
Provider Name (Legal Business Name): BROOKE THINGVOLD LMFT
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

526 LAUREL AVE APT 1
SAINT PAUL MN
55102-4684
US

IV. Provider business mailing address

526 LAUREL AVE APT 1
SAINT PAUL MN
55102-4684
US

V. Phone/Fax

Practice location:
  • Phone: 651-269-4814
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number4542
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: