MEDICARE: MRS. KIRSTEN ANNE NELSON MA, 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	101Y00000X	Counselor	LH60317307	WA
2	101YM0800X	Mental Health Counselor	LH60317307	WA

General Provider Information

NPI Number	:	1376784843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KIRSTEN ANNE NELSON MA, LMHC

Provider Business Mailing Address
First Line	:	708 BROADWAY
Second Line	:	SUITE 100-C
City	:	TACOMA
State	:	WA
Zip	:	98402-3778
Country	:	US
Telephone Number	:	253-304-1686
Fax Number	:

Provider Business Practice Location Address
First Line	:	708 BROADWAY
Second Line	:	SUITE 100-C
City	:	TACOMA
State	:	WA
Zip	:	98402-3778
Country	:	US
Telephone Number	:	253-304-1686
Fax Number	:	888-672-7215

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

Provider Enumeration Date	:	03/13/2009
Last Update Date	:	04/10/2017

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