Provider Demographics
NPI:1467076778
Name:THISSEN, HUGH (MS)
Entity Type:Individual
Prefix:MR
First Name:HUGH
Middle Name:
Last Name:THISSEN
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7265 W 220TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLE PLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:56011-9284
Mailing Address - Country:US
Mailing Address - Phone:952-444-0498
Mailing Address - Fax:
Practice Address - Street 1:202 1ST ST S
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:MN
Practice Address - Zip Code:56069-1602
Practice Address - Country:US
Practice Address - Phone:952-444-0498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-02
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)