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Individual

MS. JENNIFER MARIE NELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
8085 WAYZATA BLVD SUITE 215, GOLDEN VALLEY, MN 55426
(206) 947-2645
(651) 493-2798
Mailing address
8085 WAYZATA BLVD SUITE 215, GOLDEN VALLEY, MN 55426
(206) 947-2645
(651) 493-2798

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
LH00008407
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP60181716
WA
101YM0800X
Mental Health Counselor
LH00008407
WA
101YP2500X
Professional Counselor
00212
MN
251S00000X
Community/Behavioral Health Agency
Primary
02466
MN
251S00000X
Community/Behavioral Health Agency
LH00008407
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1912925017
WA
Enumeration date
07/17/2006
Last updated
08/27/2021
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