Provider Demographics
NPI:1598045585
Name:NELSON, KINSEY ELORA (LPC)
Entity Type:Individual
Prefix:
First Name:KINSEY
Middle Name:ELORA
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:PO BOX 16820
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83715-6820
Mailing Address - Country:US
Mailing Address - Phone:208-323-9130
Mailing Address - Fax:208-323-9070
Practice Address - Street 1:8675 W ARDENE ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-2601
Practice Address - Country:US
Practice Address - Phone:208-780-3900
Practice Address - Fax:208-321-5069
Is Sole Proprietor?:No
Enumeration Date:2011-08-22
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-5327101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional