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General NPI Number Information
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NPI Number | 1093670655
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Entity Type | Individual
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Provider Name | JULIA NELSON MDIV, MS, LPC
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Gender | Female
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Dates
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Enumeration Date | 12/17/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 375 RIVER ST STE 201
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City | MANISTEE
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State | MI
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Zip | 49660-2729
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Country | US
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Telephone | 231-714-0282
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Fax |
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Provider Business Mailing Address
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Address Line | 14613 WUOKSI AVE
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City | KALEVA
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State | MI
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Zip | 49645-9307
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Country | US
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Telephone | 231-714-4457
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6401225838
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License Number State | MI
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