Provider Demographics
NPI:1013306554
Name:NELSON, STEVEN EUGENE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:EUGENE
Last Name:NELSON
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7470 GOLDEN POND PL
Mailing Address - Street 2:STE 300
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79121-1997
Mailing Address - Country:US
Mailing Address - Phone:806-356-9047
Mailing Address - Fax:806-356-9046
Practice Address - Street 1:7470 GOLDEN POND PL
Practice Address - Street 2:STE 300
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79121-1997
Practice Address - Country:US
Practice Address - Phone:806-356-9047
Practice Address - Fax:806-356-9046
Is Sole Proprietor?:No
Enumeration Date:2015-01-21
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67065101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional