Provider Demographics
NPI:1083132823
Name:NELSON, LUANNE S (LCSW)
Entity Type:Individual
Prefix:
First Name:LUANNE
Middle Name:S
Last Name:NELSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 HOUSTON DR
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-2507
Mailing Address - Country:US
Mailing Address - Phone:501-416-4145
Mailing Address - Fax:
Practice Address - Street 1:5601 JOHN F KENNEDY BLVD STE 102
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-6758
Practice Address - Country:US
Practice Address - Phone:501-710-6711
Practice Address - Fax:501-710-6369
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-31
Last Update Date:2024-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR8432-C1041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical