Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Lacey D Corneliusen, LICSW

Individual provider Mental Health Counselor · NPI 1871819979

Lacey D Corneliusen, LICSW is a Mental Health Counselor in Minot, North Dakota. Licensed in North Dakota. Registered with an NPI since 2010.

Licensed in
ND
In the registry since
2010
Specialties on file
2
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

6301 19th Ave NW
Minot, ND 58703-8899
Phone: (701) 852-3628
Fax: (701) 852-1190
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X
Clinical Social Worker Taxonomy 1041C0700X · Licence 4558 (ND)

Record details

NPI number1871819979
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedApril 14, 2010
Last updated in NPPESDecember 31, 2013

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