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Individual
MS. CONNIE LEE NELSON
Active
Individual
MS. CONNIE LEE NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA QMHP LPCMH CCDC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
45265
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
9605696
SD
101YA0400X
Addiction (Substance Use Disorder) Counselor
ICADC2245
—
101YM0800X
Mental Health Counselor
Primary
LPCMH2116
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6576132
—
SD
Enumeration date
08/30/2005
Last updated
07/16/2026
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