Provider Demographics
NPI:1689159840
Name:TWOGOOD, ROLLEN BENJAMIN (LMFT)
Entity Type:Individual
Prefix:
First Name:ROLLEN
Middle Name:BENJAMIN
Last Name:TWOGOOD
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 DECATUR AVE N STE 109
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55427-4363
Mailing Address - Country:US
Mailing Address - Phone:763-746-2421
Mailing Address - Fax:763-746-2401
Practice Address - Street 1:5910 SHINGLE CREEK PKWY STE 150
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55430-2324
Practice Address - Country:US
Practice Address - Phone:763-569-5200
Practice Address - Fax:763-569-5201
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-03
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2789106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist