Healthcare Provider Details
I. General information
NPI: 1255295051
Provider Name (Legal Business Name): TWIN PINES COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/15/2025
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10739 CHACO TERRACE ST NW
ALBUQUERQUE NM
87114-6115
US
IV. Provider business mailing address
63108 COUNTY RD 5
FRANKLIN MN
55333
US
V. Phone/Fax
- Phone: 505-991-3150
- Fax: 866-667-2514
- Phone: 320-522-3445
- Fax: 866-667-2514
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
RYAN
JEROME
TINGLEY
Title or Position: OWNER/OPERATOR
Credential: LPCC
Phone: 320-522-3455