Provider Demographics
NPI:1780917468
Name:PHELPS NELSON, TERESA C (LMFT)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:C
Last Name:PHELPS NELSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2940 LIMITED LN NW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-6503
Mailing Address - Country:US
Mailing Address - Phone:360-586-0967
Mailing Address - Fax:360-586-0968
Practice Address - Street 1:2940 LIMITED LN NW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-6503
Practice Address - Country:US
Practice Address - Phone:360-586-0967
Practice Address - Fax:360-586-0968
Is Sole Proprietor?:No
Enumeration Date:2009-09-11
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor