Provider Demographics
NPI:1568535631
Name:NELSON, GRETCHEN J (MA, MFT, LADC)
Entity Type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:J
Last Name:NELSON
Suffix:
Gender:F
Credentials:MA, MFT, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2655 ENTERPRISE RD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89512-1666
Mailing Address - Country:US
Mailing Address - Phone:775-688-1600
Mailing Address - Fax:775-688-1616
Practice Address - Street 1:1070 PINERIDGE DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3628
Practice Address - Country:US
Practice Address - Phone:775-828-6991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0874106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist