Basic Information
| Provider Information | |||||||||
| NPI: | 1033596358 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MINDY J. NIELSEN PROFESSIONAL COUNSELING, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2454 SUMMIT ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432022727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145952344 | ||||||||
| FaxNumber: | 6144513017 | ||||||||
| Practice Location | |||||||||
| Address1: | 1115 BETHEL RD | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432202690 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145952344 | ||||||||
| FaxNumber: | 6144513017 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2015 | ||||||||
| LastUpdateDate: | 05/06/2015 | ||||||||
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| AuthorizedOfficialLastName: | NIELSEN | ||||||||
| AuthorizedOfficialFirstName: | MINDY | ||||||||
| AuthorizedOfficialMiddleName: | JONELLE | ||||||||
| AuthorizedOfficialTitleorPosition: | PROFESSIONAL COUNSELOR-CLINICAL RES | ||||||||
| AuthorizedOfficialTelephone: | 6145952344 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | PC-CR | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | C1000527-CR | OH | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor |
No ID Information.