Provider Demographics
NPI:1780771709
Name:NELSON, MARJEAN LAUGHLIN (M ED LPC)
Entity type:Individual
Prefix:MRS
First Name:MARJEAN
Middle Name:LAUGHLIN
Last Name:NELSON
Suffix:
Gender:F
Credentials:M ED LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1670 KELLER PKWY
Mailing Address - Street 2:SUITE 261
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248
Mailing Address - Country:US
Mailing Address - Phone:817-741-7999
Mailing Address - Fax:817-741-7015
Practice Address - Street 1:1670 KELLER PKWY
Practice Address - Street 2:SUITE 261
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248
Practice Address - Country:US
Practice Address - Phone:817-741-7999
Practice Address - Fax:817-741-7015
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8383101Y00000X
TX18704101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor