Provider Demographics
NPI:1437416609
Name:NIELSEN, ROBERT CAROL (EDD - LPCC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CAROL
Last Name:NIELSEN
Suffix:
Gender:M
Credentials:EDD - LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 UNIVERSITY DR N
Mailing Address - Street 2:SGC C119
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58102-1843
Mailing Address - Country:US
Mailing Address - Phone:701-231-7676
Mailing Address - Fax:701-231-9785
Practice Address - Street 1:1919 UNIVERSITY DR N
Practice Address - Street 2:SGC C119
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-1843
Practice Address - Country:US
Practice Address - Phone:701-231-7676
Practice Address - Fax:701-231-9785
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-12
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND8-12-5-90-1101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional