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General NPI Number Information
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NPI Number | 1659500759
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Entity Type | Individual
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Provider Name | RENEE LORIN NELSON DBH LPC
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Gender | Female
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Dates
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Enumeration Date | 07/09/2009
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 4539 N 22ND ST STE 4604
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City | PHOENIX
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State | AZ
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Zip | 85016-4639
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Country | US
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Telephone | 520-636-5505
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Fax |
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Provider Business Mailing Address
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Address Line | 4539 N 22ND ST STE 4604
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City | PHOENIX
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State | AZ
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Zip | 85016-4639
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Country | US
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Telephone | 520-636-5505
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Fax | 520-462-8160
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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 | LPC-MN-147
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-13206
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License Number State | AZ
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