Provider Demographics
NPI:1114104692
Name:NELSON, JEANA K (LPC)
Entity Type:Individual
Prefix:MS
First Name:JEANA
Middle Name:K
Last Name:NELSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 S CENTRAL EXPY
Mailing Address - Street 2:SUITE 608
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-3864
Mailing Address - Country:US
Mailing Address - Phone:972-569-8255
Mailing Address - Fax:972-569-8977
Practice Address - Street 1:1500 S CENTRAL EXPY
Practice Address - Street 2:SUITE 608
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-3864
Practice Address - Country:US
Practice Address - Phone:972-569-8255
Practice Address - Fax:972-569-8977
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-27
Last Update Date:2008-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62982101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX62982OtherLPC