Provider Demographics
NPI:1699089243
Name:NELSON, LYNAE M (LPC)
Entity type:Individual
Prefix:MRS
First Name:LYNAE
Middle Name:M
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 1:4800 MEADOWS ROAD
Mailing Address - Street 2:SUITE #300
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-0026
Mailing Address - Country:US
Mailing Address - Phone:971-201-1720
Mailing Address - Fax:541-726-2467
Practice Address - Street 1:4800 MEADOWS ROAD
Practice Address - Street 2:SUITE #300
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-0026
Practice Address - Country:US
Practice Address - Phone:971-201-1720
Practice Address - Fax:541-726-2467
Is Sole Proprietor?:No
Enumeration Date:2010-08-05
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
ORC4674101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health