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General NPI Number Information
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NPI Number | 1033006978
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Entity Type | Individual
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Provider Name | ZACHARY NELSON LPC
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Gender | Male
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 412 WASHINGTON AVE
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City | WEST PLAINS
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State | MO
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Zip | 65775-3432
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Country | US
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Telephone | 417-274-0469
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Fax | 417-503-1442
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Provider Business Mailing Address
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Address Line | 4670 COUNTY ROAD 2630
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City | POMONA
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State | MO
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Zip | 65789-8113
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Country | US
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Telephone | 417-274-0469
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Fax | 417-530-1442
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2025021253
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License Number State | MO
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