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NPI Code Detail

MEDICARE: MS. KAREN K NIELSEN LCSW, MSW

MEDICARE: MS. KAREN K NIELSEN LCSW, MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerCSW.09926324CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1313509OTHERWYBS

General Provider Information

NPI Number : 1376524496
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KAREN K NIELSEN LCSW, MSW
Provider Business Mailing Address
First Line : 4856 INNOVATION DR STE B
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-5540
Country : US
Telephone Number : 970-494-4200
Fax Number :
Provider Business Practice Location Address
First Line : 1250 N WILSON AVE
Second Line :
City : LOVELAND
State : CO
Zip : 80537-4461
Country : US
Telephone Number : 970-494-4200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2005
Last Update Date : 01/22/2020

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