Provider Demographics
NPI:1215910070
Name:NELSON, DELORIS (LPC)
Entity type:Individual
Prefix:
First Name:DELORIS
Middle Name:
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 1:1006 S SHORE DR
Mailing Address - Street 2:
Mailing Address - City:KEMAH
Mailing Address - State:TX
Mailing Address - Zip Code:77565-2490
Mailing Address - Country:US
Mailing Address - Phone:281-334-2272
Mailing Address - Fax:281-334-2272
Practice Address - Street 1:1006 S SHORE DR
Practice Address - Street 2:3
Practice Address - City:KEMAH
Practice Address - State:TX
Practice Address - Zip Code:77565-2490
Practice Address - Country:US
Practice Address - Phone:281-334-2272
Practice Address - Fax:281-334-2272
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9020101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional