Provider Demographics
NPI:1386624336
Name:NELSON, HOWARD EUGENE (PHD,LPC-MSHP, LCPT)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:EUGENE
Last Name:NELSON
Suffix:
Gender:M
Credentials:PHD,LPC-MSHP, LCPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3152 BEECHRUN CV
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-4406
Mailing Address - Country:US
Mailing Address - Phone:901-387-1050
Mailing Address - Fax:901-387-0155
Practice Address - Street 1:2600 POPLAR AVE
Practice Address - Street 2:SUITE 516
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38112-3851
Practice Address - Country:US
Practice Address - Phone:901-240-2839
Practice Address - Fax:901-387-0155
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000000674101YM0800X
TNLCPT0000000028101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral