MEDICARE: ELIZABETH VADA NELSON LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	068.0135088	VT
2	101YM0800X	Mental Health Counselor	IMH13113	FL
3	101YM0800X	Mental Health Counselor	LCPC-9385	ID
4	101YP2500X	Professional Counselor	39004486A	IN
5	101YM0800X	Mental Health Counselor	6557	TN
6	101YM0800X	Mental Health Counselor	MI-0000087	DE
7	101YP2500X	Professional Counselor	LPC014025	GA
8	101YM0800X	Mental Health Counselor	MH16594	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285124552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH VADA NELSON LMHC

Provider Business Mailing Address
First Line	:	2889 WINDSOR HEIGHTS ST
Second Line	:
City	:	DELTONA
State	:	FL
Zip	:	32738-2487
Country	:	US
Telephone Number	:	386-343-3874
Fax Number	:

Provider Business Practice Location Address
First Line	:	2889 WINDSOR HEIGHTS ST
Second Line	:
City	:	DELTONA
State	:	FL
Zip	:	32738-2487
Country	:	US
Telephone Number	:	386-343-3874
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2018
Last Update Date	:	06/02/2025

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