MEDICARE: AMANDA NELSON MA, LMFT

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
1	106H00000X	Marriage & Family Therapist	2217	MN

General Provider Information

NPI Number	:	1528470960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA NELSON MA, LMFT

Provider Business Mailing Address
First Line	:	633 SW 6TH ST
Second Line	:
City	:	BRAINERD
State	:	MN
Zip	:	56401-3999
Country	:	US
Telephone Number	:	218-537-0272
Fax Number	:

Provider Business Practice Location Address
First Line	:	11985 MAPLEWOOD RIDGE CT
Second Line	:
City	:	EAST GULL LAKE
State	:	MN
Zip	:	56401-7501
Country	:	US
Telephone Number	:	218-537-0272
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2014
Last Update Date	:	03/16/2026

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