Provider Demographics
NPI:1730644311
Name:NELSEN, KALEIGH JO (LMHP, CMSW)
Entity Type:Individual
Prefix:
First Name:KALEIGH
Middle Name:JO
Last Name:NELSEN
Suffix:
Gender:F
Credentials:LMHP, CMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 CENTRAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-3461
Mailing Address - Country:US
Mailing Address - Phone:402-742-8800
Mailing Address - Fax:
Practice Address - Street 1:2444 O ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-1125
Practice Address - Country:US
Practice Address - Phone:402-475-7666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-07
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2094104100000X
NE57601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker