Healthcare Provider Details

I. General information

NPI: 1881245587
Provider Name (Legal Business Name): NAIMA HUSSEIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2019
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 DIVISION ST STE D
WAITE PARK MN
56387-1389
US

IV. Provider business mailing address

130 DIVISION ST STE D
WAITE PARK MN
56387-1389
US

V. Phone/Fax

Practice location:
  • Phone: 320-200-9229
  • Fax:
Mailing address:
  • Phone: 320-200-9229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5719
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: