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General NPI Number Information
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NPI Number | 1265089320
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Entity Type | Individual
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Provider Name | KENYA NICOLE NELSON
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Gender | Female
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Dates
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Enumeration Date | 08/23/2019
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Last Update Date | 02/20/2026
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Provider Practice Location Address
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Address Line | 11816 INWOOD RD # 3303
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City | DALLAS
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State | TX
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Zip | 75244-8011
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Country | US
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Telephone | 469-215-7232
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Fax |
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Provider Business Mailing Address
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Address Line | 1228 FLOWER RIDGE DR
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City | LANCASTER
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State | TX
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Zip | 75134-1662
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Country | US
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Telephone | 469-265-5603
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 61444
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License Number State | TX
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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 | 135608
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 18636
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License Number State | LA
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW25292
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License Number State | FL
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