Provider Demographics
NPI:1366098824
Name:NELSON, REBECCA (LMHC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3803 S LANCEWOOD PL
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-1279
Mailing Address - Country:US
Mailing Address - Phone:757-274-5562
Mailing Address - Fax:
Practice Address - Street 1:3803 S LANCEWOOD PL
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-1279
Practice Address - Country:US
Practice Address - Phone:754-282-2289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-12
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008814101YM0800X
FLMH17729101YM0800X
FLPMH1658101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health