Individual
MR. CHARLES FRANCIS NIELSEN II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, CPSS
Contact information
Practice address
9196 W EMERALD ST STE 135, BOISE, ID 83704-8004
(208) 323-4400
Mailing address
4460 S HIGHLAND DR, SALT LAKE CITY, UT 84124-3543
(888) 949-4864
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
ID
101YM0800X
Mental Health Counselor
LPC-6665
ID
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
08/30/2017
Last updated
01/08/2021
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