# TWIN CITIES TEEN COUNSELING LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255805800
- **Authorized official:** JENNIFER KORTGARD LICSW (OWNER)
- **Authorized official phone:** (612) 548-4948

## Contact information

- **Practice address:** 2375 UNIVERSITY AVE W STE 160, SAINT PAUL, MN 55114-1632
- **Practice address phone:** (612) 548-4948
- **Mailing address:** 2618 N 4TH ST, MINNEAPOLIS, MN 55411-2159

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 01/16/2019
- **Last updated:** 01/16/2019