Provider Demographics
NPI:1255631727
Name:NIELSEN, VIRGINIA (MA, LPC)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:NIELSEN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14201 S MUR LEN RD
Mailing Address - Street 2:STE 202
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1884
Mailing Address - Country:US
Mailing Address - Phone:913-735-7176
Mailing Address - Fax:
Practice Address - Street 1:14201 S MUR LEN RD
Practice Address - Street 2:STE 202
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1884
Practice Address - Country:US
Practice Address - Phone:913-735-7176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2182101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor