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Individual
MR. JAY MICHAEL NELSON
Active
Individual
MR. JAY MICHAEL NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT, CADCI
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
08-12-37
OR
172V00000X
Community Health Worker
8086
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1042985
ASHNET - AMERICAN SPECIALTY HEALTH NETWORK
OR
05
—
278095
—
OR
Enumeration date
11/07/2008
Last updated
03/09/2023
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