Provider Demographics
NPI:1326059197
Name:NELSON, DANIEL S (MA/LPCC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:S
Last Name:NELSON
Suffix:
Gender:M
Credentials:MA/LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 4TH ST SW
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-3330
Mailing Address - Country:US
Mailing Address - Phone:320-214-8558
Mailing Address - Fax:320-235-2733
Practice Address - Street 1:214 4TH ST SW
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-3330
Practice Address - Country:US
Practice Address - Phone:320-214-8558
Practice Address - Fax:320-235-2733
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN00152101YP2500X
MNCC00031101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional