MEDICARE: AUSTIN NELSON 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
1	101YP2500X	Professional Counselor	0701016284	VA

General Provider Information

NPI Number	:	1609701119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUSTIN NELSON LPC

Provider Business Mailing Address
First Line	:	1047 VISTA PARK DR
Second Line	:
City	:	FOREST
State	:	VA
Zip	:	24551-0295
Country	:	US
Telephone Number	:	434-616-2388
Fax Number	:

Provider Business Practice Location Address
First Line	:	1047 VISTA PARK DR
Second Line	:
City	:	FOREST
State	:	VA
Zip	:	24551-0295
Country	:	US
Telephone Number	:	434-616-2388
Fax Number	:

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

Provider Enumeration Date	:	06/16/2026
Last Update Date	:	06/16/2026

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