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NPI Code Detail

MEDICARE: DR. PEARL RICHARD NELSON PH.D, LPC

MEDICARE:  DR. PEARL RICHARD NELSON  PH.D, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor2476LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1497063473
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PEARL RICHARD NELSON PH.D, LPC
Provider Business Mailing Address
First Line : 1925 ENTERPRISE BLVD
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70601-6371
Country : US
Telephone Number : 337-429-5129
Fax Number : 337-214-2077
Provider Business Practice Location Address
First Line : 1925 ENTERPRISE BLVD
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70601-6371
Country : US
Telephone Number : 337-429-5129
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2010
Last Update Date : 09/17/2021

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Directions to “ DR. PEARL RICHARD NELSON PH.D, LPC” Practice Location

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