Provider Demographics
NPI:1821412032
Name:NELSON, DAWN (LPC, NCC, MA)
Entity type:Individual
Prefix:MS
First Name:DAWN
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:LPC, NCC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7791
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CO
Mailing Address - Zip Code:81620-7791
Mailing Address - Country:US
Mailing Address - Phone:970-904-2558
Mailing Address - Fax:
Practice Address - Street 1:100 WEST BEAVER CREEK BLVD
Practice Address - Street 2:SUITE 218
Practice Address - City:AVON
Practice Address - State:CO
Practice Address - Zip Code:81620-7791
Practice Address - Country:US
Practice Address - Phone:970-904-2558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-07
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC.0103242101YM0800X
CO0012452101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health