Provider Demographics
NPI:1285902569
Name:NELSON, DONALD BURTON (LPC, CDCI)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:BURTON
Last Name:NELSON
Suffix:
Gender:M
Credentials:LPC, CDCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 COLUMBINE ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-3047
Mailing Address - Country:US
Mailing Address - Phone:928-373-8488
Mailing Address - Fax:
Practice Address - Street 1:1409 COLUMBINE ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-3047
Practice Address - Country:US
Practice Address - Phone:928-373-8488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-01
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK854101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional