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Organization
TWIN CITIES TEEN COUNSELING LLC
Active
Organization
TWIN CITIES TEEN COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER KORTGARD LICSW (OWNER)
(612) 548-4948
Entity
Organization
Contact information
Practice address
2375 UNIVERSITY AVE W STE 160, SAINT PAUL, MN 55114-1632
(612) 548-4948
Mailing address
2618 N 4TH ST, MINNEAPOLIS, MN 55411-2159
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/16/2019
Last updated
01/16/2019
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