Benjamin Taylor Neilsen

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

4704360521 Issued in MI

Practice address

6071 W Outer Dr
Detroit, MI 48235-2624

Phone

(802) 338-0481

NPI assigned

Jan 20, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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": "1674172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1144935487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19000 PURITAN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482231352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6071 W OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352624",
            "telephone_number": "802-338-0481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEILSEN",
        "first_name": "BENJAMIN",
        "middle_name": "TAYLOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-20",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "MI",
            "license": "4704360521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neighborhood Service Organization
• Neighborhood Service Organization
• Neightborhood Service Organization
• Emily Neihsl
• Daniel Neill, M.D.
• Amanda Lee Neilson, NP
• Christina Neirinck, FNP-BC
• Nekton Autism of Michigan LLC
• Ebony Nellon, RN
• Lakshmi Subba Nellutla, MD

• Adult Psychiatric/Mental Health Registered Nurse in Detroit, MI
• Providers in Detroit, MI by specialty
• Adult Psychiatric/Mental Health Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; 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.