Provider Demographics
NPI:1609915396
Name:NIELSEN, REBECCA LYNN (LCPC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:NIELSEN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1626 6TH AVE N
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-1720
Mailing Address - Country:US
Mailing Address - Phone:406-231-5765
Mailing Address - Fax:
Practice Address - Street 1:1626 6TH AVE N
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-1720
Practice Address - Country:US
Practice Address - Phone:406-231-5765
Practice Address - Fax:406-727-3799
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-18676101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health