Doctor Name: | NIELS WILLIAM NIELSEN |
NPI Number: | 1013040963 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LISW |
License Number: | I2504 |
Business Practice Address: | 38879 Mentor Ave Suite C Willoughby, OH - 440947992 |
Business Phone Number: | 4409539999 |
Business Fax Number: | 4409183839 |
Mailing Address: | 38879 Mentor Ave, Suite C WILLOUGHBY |
State: | OH |
Postal Code: | 440947992 |
Phone Number: | 4409539999 |
Fax Number: | 4409183839 |
NPI Enumeration Date: | 03/13/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | I2504 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |