Provider Demographics
NPI:1518096494
Name:NELSON, JAMES PRESTON (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:PRESTON
Last Name:NELSON
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3475 YULE TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-1243
Mailing Address - Country:US
Mailing Address - Phone:307-631-6672
Mailing Address - Fax:307-635-3967
Practice Address - Street 1:515 E CARLSON ST
Practice Address - Street 2:UNIT 104
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-4256
Practice Address - Country:US
Practice Address - Phone:307-638-4092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1388101YP2500X
WY1108101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional