Provider Demographics
NPI:1588927743
Name:NELSON, ASHLIE (LPC)
Entity type:Individual
Prefix:MRS
First Name:ASHLIE
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 1:1933 NW 39TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-2611
Mailing Address - Country:US
Mailing Address - Phone:405-314-2920
Mailing Address - Fax:
Practice Address - Street 1:5929 N MAY AVE STE 304
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-3910
Practice Address - Country:US
Practice Address - Phone:405-314-2920
Practice Address - Fax:405-286-0362
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6527261QM0801X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200114430AMedicaid