Lacey Corneliusen, Licsw, LLC
NPI #1285064246 in Minot, North Dakota
Provider Information
- NPI Number
- 1285064246
- Entity Type
- Organization
- Organization Name
- Lacey Corneliusen, Licsw, LLC
- Primary Specialty
- Social Worker - Clinical
- Enumeration Date
- Nov 12, 2013
- Last Updated
- Nov 12, 2013
Practice Location
- Address
- 315 MAIN ST S
- Address 2
- STE 301
- City
- Minot
- State
- North Dakota
- ZIP Code
- 58701-3956
- Phone
- (406) 939-1976
Authorized Official
- Name
- MRS. LACEY DAWN CORNELISEN, LICSW
- Title
- THERAPIST
- Phone
- (406) 939-1976
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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