Provider Demographics
NPI:1376224766
Name:HASSAN, ABDIRIZAK
Entity Type:Individual
Prefix:
First Name:ABDIRIZAK
Middle Name:
Last Name:HASSAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 ORENDORFF WAY NE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-5050
Mailing Address - Country:US
Mailing Address - Phone:651-363-6866
Mailing Address - Fax:
Practice Address - Street 1:2554 COMO AVE STE 6
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55108-1249
Practice Address - Country:US
Practice Address - Phone:651-363-6866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor