Provider Demographics
NPI:1821611039
Name:DUFEK, HA PHUONG NGOC (LPCC, LADC)
Entity Type:Individual
Prefix:
First Name:HA
Middle Name:PHUONG NGOC
Last Name:DUFEK
Suffix:
Gender:F
Credentials:LPCC, LADC
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:PHUONG NGOC
Other - Last Name:DUFEK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:712 68TH LN N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-2842
Mailing Address - Country:US
Mailing Address - Phone:763-464-7898
Mailing Address - Fax:
Practice Address - Street 1:7601 WAYZATA BLVD
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55426-1626
Practice Address - Country:US
Practice Address - Phone:612-223-8898
Practice Address - Fax:612-223-8899
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-21
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MN3437101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health