Provider Demographics
NPI:1215399464
Name:NELSON COUNSELING, LLC
Entity Type:Organization
Organization Name:NELSON COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MARI
Authorized Official - Middle Name:CHRISTINA
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, ICADC, DBTC
Authorized Official - Phone:208-421-4293
Mailing Address - Street 1:488 BLUE LAKES BLVD N
Mailing Address - Street 2:SUITE 108
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-4800
Mailing Address - Country:US
Mailing Address - Phone:208-421-4293
Mailing Address - Fax:
Practice Address - Street 1:236 BELLEVUE CT
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-5600
Practice Address - Country:US
Practice Address - Phone:208-421-4293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-27
Last Update Date:2016-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-6017251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health