Individual
MR. STEPHEN B NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
690 S INDUSTRY WAY STE 45, MERIDIAN, ID 83642-7907
(208) 278-6807
(208) 493-4885
Mailing address
PO BOX 1578, MERIDIAN, ID 83680-1578
(208) 278-6807
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LCPC-6320
ID
101Y00000X
Counselor
LPC-5279
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LCPC-6320
—
ID
Enumeration date
09/11/2013
Last updated
08/17/2023
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