Provider Demographics
NPI:1619848389
Name:HUSSEIN, ABDULHAFID ABDULKADIR
Entity type:Individual
Prefix:
First Name:ABDULHAFID
Middle Name:ABDULKADIR
Last Name:HUSSEIN
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 1:700 5TH ST S
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-7764
Mailing Address - Country:US
Mailing Address - Phone:612-417-5999
Mailing Address - Fax:651-666-4104
Practice Address - Street 1:700 5TH ST S
Practice Address - Street 2:
Practice Address - City:HOPKINS
Practice Address - State:MN
Practice Address - Zip Code:55343-7764
Practice Address - Country:US
Practice Address - Phone:612-417-5999
Practice Address - Fax:651-666-4104
Is Sole Proprietor?:No
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician