Suzanne Marie Nielsen

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

25-QMHA-I-004982 Issued in OR

Practice address

770 E 11TH Ave
Eugene, OR 97401-3746

Phone

(458) 205-7085

Fax

(458) 205-6924

NPI assigned

May 6, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1588723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1124649660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 MAJOR AVE",
            "city": "RIVERTON",
            "state": "WY",
            "postal_code": "825012342",
            "telephone_number": "307-856-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 E 11TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013746",
            "telephone_number": "458-205-7085",
            "fax_number": "458-205-6924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Hilyard St Ste 310",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974018122",
            "country_code": "US",
            "telephone_number": "458-205-6709",
            "fax_number": "458-205-6708",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1110 Major Ave",
            "address_purpose": "LOCATION",
            "city": "Riverton",
            "state": "WY",
            "postal_code": "825012342",
            "country_code": "US",
            "telephone_number": "307-856-6587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "SUZANNE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-06",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "25-QMHA-I-004982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Elaine Nickle
• Andrea Thea Nicodemus, LMT 25036
• Brandon Elias Nielsen
• Destanie Lawann Keasha Nielsen
• Masami Nielsen, LMT
• Jesse Lynn Nielson, CRM
• Suzanne Kent Nieman, PMHNP-BC
• Michelle Lynne Niesley, N.D.
• Eric James Niespodzany, M.D.
• Kevin Michael Nieto

• Mental Health Counselor in Eugene, OR
• Providers in Eugene, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.