Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mallyssa Rose Nissen

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1336949262

Mallyssa Rose Nissen is an Addiction (Substance Use Disorder) Counselor in Brooklyn Park, Minnesota. Licensed in Minnesota. Registered with an NPI since 2025.

Licensed in
MN
In the registry since
2025
Specialties on file
2

Practice location Address checks out

6800 78th Ave N
Brooklyn Park, MN 55445-2758
Phone: (612) 314-0349
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 307186 (MN)

Record details

NPI number1336949262
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 18, 2025
Last updated in NPPESApril 18, 2025
Certification dateApril 18, 2025

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