Provider Demographics
NPI:1285124552
Name:NELSON, ELIZABETH VADA (LMHC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:VADA
Last Name:NELSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2889 WINDSOR HEIGHTS ST
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-2487
Mailing Address - Country:US
Mailing Address - Phone:386-343-3874
Mailing Address - Fax:
Practice Address - Street 1:2889 WINDSOR HEIGHTS ST
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32738-2487
Practice Address - Country:US
Practice Address - Phone:386-343-3874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-13
Last Update Date:2023-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0135088101YM0800X
IDLCPC-9385101YM0800X
TN6557101YM0800X
DEMI-0000087101YM0800X
FLIMH13113101YM0800X
IN39004486A101YP2500X
GALPC014025101YP2500X
FLMH16594101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional