Provider Demographics
NPI:1699314427
Name:NILSEN, BRITNEY NICOLE (CSW)
Entity type:Individual
Prefix:
First Name:BRITNEY
Middle Name:NICOLE
Last Name:NILSEN
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2175 W 3950 S
Mailing Address - Street 2:
Mailing Address - City:ROY
Mailing Address - State:UT
Mailing Address - Zip Code:84067-3537
Mailing Address - Country:US
Mailing Address - Phone:801-631-2129
Mailing Address - Fax:
Practice Address - Street 1:2661 WASHINGTON BLVD STE 102
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-3606
Practice Address - Country:US
Practice Address - Phone:801-621-8670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-26
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11343989-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical