Provider Demographics
NPI:1154591642
Name:NELSON, ROBIN BECK (LPC)
Entity type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:BECK
Last Name:NELSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4320 SOUTHPORT SUPPLY RD SE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SOUTHPORT
Mailing Address - State:NC
Mailing Address - Zip Code:28461-8158
Mailing Address - Country:US
Mailing Address - Phone:910-457-0800
Mailing Address - Fax:910-457-1072
Practice Address - Street 1:4320 SOUTHPORT SUPPLY RD SE
Practice Address - Street 2:SUITE 200
Practice Address - City:SOUTHPORT
Practice Address - State:NC
Practice Address - Zip Code:28461-8158
Practice Address - Country:US
Practice Address - Phone:910-457-0800
Practice Address - Fax:910-457-1072
Is Sole Proprietor?:No
Enumeration Date:2008-03-11
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLPC11199101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional