Craig Nelson

Individual provider Active NPI Mental Health Counselor · Boardman, OR

NPI 1164031423 · NPPES record last updated Jul 23, 2020

Key facts

NPI
1164031423
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
104 SW Kinkade Ave
Boardman, OR 97818
Phone
(541) 481-2911
NPI assigned
Jul 23, 2020
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Community Counseling Solutions Mental Health Past
since Aug 2, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

104 SW Kinkade Ave
Boardman, OR 97818

Mailing address

PO Box 261
Boardman, OR 97818-0261
Phone (541) 481-2911

Other providers in Boardman, OR

All providers in Boardman, OR · Mental Health Counselor in Oregon

Sources for this page

Verify at the official NPI Registry.