Provider Demographics
NPI:1306000203
Name:NIELSEN, TROY (LMHC)
Entity Type:Individual
Prefix:MR
First Name:TROY
Middle Name:
Last Name:NIELSEN
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:749 CHAMBERLIN TRL
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34772-7396
Mailing Address - Country:US
Mailing Address - Phone:407-924-6549
Mailing Address - Fax:
Practice Address - Street 1:749 CHAMBERLIN TRL
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34772-7396
Practice Address - Country:US
Practice Address - Phone:407-924-6549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 7931101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL767357400Medicaid