Healthcare Provider Details

I. General information

NPI: 1194322297
Provider Name (Legal Business Name): DYONNA A NELSON LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2020
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8258 VETERANS HWY STE 13
MILLERSVILLE MD
21108-1564
US

IV. Provider business mailing address

8258 VETERANS HWY STE 13
MILLERSVILLE MD
21108-1564
US

V. Phone/Fax

Practice location:
  • Phone: 410-757-2077
  • Fax:
Mailing address:
  • Phone: 410-757-2077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC16543
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: