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NPI Code Detail

MEDICARE: MRS. MELISSA DAWN NELSON MA, LPC

MEDICARE: MRS. MELISSA DAWN NELSON MA, 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 CounselorLPC-10764AZ

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 : 1720489354
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MELISSA DAWN NELSON MA, LPC
Provider Business Mailing Address
First Line : 2451 E BASELINE RD
Second Line :
City : GILBERT
State : AZ
Zip : 85234-2471
Country : US
Telephone Number : 480-734-3851
Fax Number : 480-623-0026
Provider Business Practice Location Address
First Line : 2451 E BASELINE RD STE 430
Second Line :
City : GILBERT
State : AZ
Zip : 85234-2473
Country : US
Telephone Number : 480-734-3851
Fax Number : 480-623-0026
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2014
Last Update Date : 09/15/2014

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