Individual
NAOMI NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPCC
Contact information
Practice address
37218 COUNTY ROAD 66, CROSSLAKE, MN 56442-2529
(218) 692-5151
Mailing address
7888 LOGGING LN, BREEZY POINT, MN 56472-3927
(218) 371-6839
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
CC03462
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CC03462
MINNESOTA BOARD OF BEHAVIORAL HEALTH AND THERAPY
MN
Enumeration date
08/19/2022
Last updated
09/12/2022
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