Provider Demographics
NPI:1932497757
Name:THIELEN, AUDREY L (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:AUDREY
Middle Name:L
Last Name:THIELEN
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 1:600 S SANTA FE AVE STE C
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-4171
Mailing Address - Country:US
Mailing Address - Phone:785-445-6111
Mailing Address - Fax:785-893-6451
Practice Address - Street 1:600 S SANTA FE AVE STE C
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-4171
Practice Address - Country:US
Practice Address - Phone:785-445-6111
Practice Address - Fax:785-893-6451
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2163101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional