Jackie Nelson, PLLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

JACKIE NELSON, PLLC

Practice address

202 N 9TH St Ste 401C
Boise, ID 83702-5770

Phone

(208) 639-9192

NPI assigned

Jan 30, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jacquelyn Nelson, M.S.C, LCPCNPI 1386183135

Title

Owner and Counselor

Phone

(480) 316-5462

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacquelyn Nelson, M.S.C

  • Professional Counselor
  • Mesa, AZ
  • NPI 1386183135
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580342400000",
    "number": "1033740865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4621 W KENDALL ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837062222",
            "telephone_number": "480-316-5462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 N 9TH ST STE 401C",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837025770",
            "telephone_number": "208-639-9192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKIE NELSON, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-30",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "JACQUELYN",
        "authorized_official_title_or_position": "OWNER AND COUNSELOR",
        "authorized_official_telephone_number": "480-316-5462",
        "authorized_official_credential": "M.S.C, LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marina A Izzi, PHARMD
• J and E Services, LLC
• J Macmillan Bruce DDS Inc
• J. Randall Pitman & Associates, P.C.
• Jane Jablonski, LPC
• Shelley Marie Jacks, MD
• Ashley Jackson, PHARMD
• Caleb Jackson
• Chad Harman Jackson, MD
• Derek Dean Jackson, MD

• Adult Mental Health Clinic/Center in Boise, ID
• Providers in Boise, ID by specialty
• Adult Mental Health Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.