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General NPI Number Information
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NPI Number | 1063910131
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Entity Type | Organization
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Legal Business Name | LISA NELSON LCSW PLLC
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Dates
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Enumeration Date | 01/24/2018
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Last Update Date | 05/02/2023
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Provider Practice Location Address
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Address Line | 5353 W DARTMOUTH AVE STE 203
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City | DENVER
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State | CO
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Zip | 80227-5516
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Country | US
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Telephone | 720-588-0836
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Fax |
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Provider Business Mailing Address
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Address Line | 2685 S PENNSYLVANIA ST
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City | DENVER
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State | CO
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Zip | 80210-5723
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Country | US
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Telephone | 720-588-0836
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Fax | 720-306-5450
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Authorized Official
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Title or Position | OWNER/PSYCHOTHERAPIST
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Name | LISA R NELSON
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Credential | LCSW
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Telephone | 408-655-0711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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