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General NPI Number Information
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NPI Number | 1124696232
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Entity Type | Individual
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Provider Name | MAURICA LADAUGHN NELSEN LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/15/2021
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 818 W JENICEK LOOP
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City | POST FALLS
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State | ID
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Zip | 83854-4988
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Country | US
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Telephone | 208-819-6467
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Fax | 509-434-7156
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Provider Business Mailing Address
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Address Line | 4815 N ASSEMBLY ST
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City | SPOKANE
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State | WA
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Zip | 99205-6185
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Country | US
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Telephone | 509-434-7319
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Fax | 509-434-7156
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 39314
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License Number State | ID
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