Provider Demographics
NPI:1669851309
Name:NELSON, REMY (LMHC)
Entity Type:Individual
Prefix:MR
First Name:REMY
Middle Name:
Last Name:NELSON
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 INVERRARY BLVD
Mailing Address - Street 2:STE 408B
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33319-4359
Mailing Address - Country:US
Mailing Address - Phone:954-533-6453
Mailing Address - Fax:
Practice Address - Street 1:3800 INVERRARY BLVD
Practice Address - Street 2:STE 408B
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-4359
Practice Address - Country:US
Practice Address - Phone:954-533-6453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-27
Last Update Date:2017-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 10889101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health