Provider Demographics
NPI:1457765992
Name:NELSON, SARAH M Y (MA, NCC, LCPC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:M Y
Last Name:NELSON
Suffix:
Gender:F
Credentials:MA, NCC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 SOUTH AVE W STE D
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-8011
Mailing Address - Country:US
Mailing Address - Phone:406-552-9941
Mailing Address - Fax:406-258-0433
Practice Address - Street 1:700 SOUTH AVE W STE D
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-8011
Practice Address - Country:US
Practice Address - Phone:406-552-9941
Practice Address - Fax:406-258-0433
Is Sole Proprietor?:No
Enumeration Date:2014-06-12
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional