Provider Demographics
NPI:1831703545
Name:NELSON, REKITA (LPC, LPASTC)
Entity type:Individual
Prefix:MS
First Name:REKITA
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:LPC, LPASTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 SECRETARIAT DR
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-1786
Mailing Address - Country:US
Mailing Address - Phone:757-660-0515
Mailing Address - Fax:
Practice Address - Street 1:152 SECRETARIAT DR
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-1786
Practice Address - Country:US
Practice Address - Phone:757-660-0515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-01
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704013293101YM0800X
VA0701014009101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty