Provider Demographics
NPI:1003964891
Name:NELSON, JAMES A (PHD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:NELSON
Suffix:
Gender:M
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 COLFAX AVE N
Mailing Address - Street 2:SUITE 130
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55405-1419
Mailing Address - Country:US
Mailing Address - Phone:612-759-8789
Mailing Address - Fax:612-823-3869
Practice Address - Street 1:227 COLFAX AVE N
Practice Address - Street 2:SUITE 130
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55405-1419
Practice Address - Country:US
Practice Address - Phone:612-759-8789
Practice Address - Fax:612-823-3869
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN519106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist