Provider Demographics
NPI:1811234651
Name:NELSON, DE ANA DAWN (MA, LPC, SAC)
Entity Type:Individual
Prefix:MRS
First Name:DE ANA
Middle Name:DAWN
Last Name:NELSON
Suffix:
Gender:F
Credentials:MA, LPC, SAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74840 COUNTY HIGHWAY A
Mailing Address - Street 2:
Mailing Address - City:IRON RIVER
Mailing Address - State:WI
Mailing Address - Zip Code:54847-7535
Mailing Address - Country:US
Mailing Address - Phone:715-813-0440
Mailing Address - Fax:833-536-1749
Practice Address - Street 1:74840 COUNTY HIGHWAY A
Practice Address - Street 2:
Practice Address - City:IRON RIVER
Practice Address - State:WI
Practice Address - Zip Code:54847-7535
Practice Address - Country:US
Practice Address - Phone:715-813-0440
Practice Address - Fax:833-536-1749
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-14
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15935-131101YA0400X
WI5667-127101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)