Provider Demographics
NPI:1487121695
Name:NIELSEN, ALEXIS (LMFT)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:NIELSEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:
Other - Last Name:FLORENCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5231 DICKENS DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-7705
Mailing Address - Country:US
Mailing Address - Phone:702-540-8687
Mailing Address - Fax:
Practice Address - Street 1:5231 DICKENS DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-7705
Practice Address - Country:US
Practice Address - Phone:702-540-8687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-25
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMI1092106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVMI1092OtherINTERN LICENSE
NV14438971Medicaid
NV3184OtherLMFT