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Individual

LUCAS JAMES NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LICSW

Contact information

Practice address
151 S 4TH ST STE 201, GRAND FORKS, ND 58201-4715
(701) 787-8569
(701) 787-5918
Mailing address
PO BOX 5196, GRAND FORKS, ND 58206-5196
(701) 787-8569
(701) 787-5918

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4336
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
054519
ND
Enumeration date
03/14/2007
Last updated
10/08/2014
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