Individual provider · Type 1 NPI

Lacey D. Corneliusen, LICSW

Mental Health Counselor · Minot, ND

NPI number 1871819979 Active

Practice location

6301 19th Ave NW
Minot, ND 58703-8899

Fax (701) 852-1190

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed
Clinical Social Worker 1041C0700X4558 (ND)

Mental Health Counselor: Definition to come...

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About NPI 1871819979

Lacey D. Corneliusen, LICSW's National Provider Identifier is 1871819979, issued on Apr 14, 2010. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Minot, ND. The record was last updated on Dec 31, 2013.