Provider Demographics
NPI:1023904836
Name:HUSSEIN, RIDWAN HASSAN
Entity type:Individual
Prefix:
First Name:RIDWAN
Middle Name:HASSAN
Last Name:HUSSEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 KILLEBREW DR STE 112
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-1871
Mailing Address - Country:US
Mailing Address - Phone:952-212-0358
Mailing Address - Fax:612-326-6160
Practice Address - Street 1:2720 SUPERIOR DR NW STE 101
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-1775
Practice Address - Country:US
Practice Address - Phone:952-212-0358
Practice Address - Fax:612-326-6160
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health