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General NPI Number Information
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NPI Number | 1801399795
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Entity Type | Organization
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Legal Business Name | BRETT NELSON COUNSELING SERVICES
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Dates
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Enumeration Date | 03/16/2018
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Last Update Date | 03/16/2018
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Provider Practice Location Address
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Address Line | 11927 MENAUL BLVD NE STE 101
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-2457
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Country | US
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Telephone | 505-275-1155
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Fax | 505-275-1156
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Provider Business Mailing Address
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Address Line | 11927 MENAUL BLVD NE STE 101
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-2457
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Country | US
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Telephone | 505-275-1155
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Fax | 505-275-1156
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Authorized Official
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Title or Position | OWNER/COUNSELOR-PSYCHOTHERAPIST
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Name | MRS. BRETT ALAN NELSON
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Credential | MA, CMHC, NCC, CCTP
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Telephone | 505-275-1155
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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 | 0954
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License Number State | NM
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