Jacqueline Rose Nelson, MA, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH60945013 Issued in WA

Practice address

1717 W Francis Ave Ste 204
Spokane, WA 99205-6858

Phone

(509) 795-0988

NPI assigned

May 25, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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

• A Refuge: Trauma Informed Therapies, a Nonprofit Organization

  dba A Refuge: Trauma Informed Therapies

  • Clinical Social Worker
  • Spokane, WA
  • NPI 1457916710

  Mental Health

  NPD (past)
• Trauma Informed Therapies

  • Clinical Social Worker
  • Spokane, WA
  • NPI 1982158614
  NPD (past)

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

{
    "created_epoch": "1527206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1336630235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 W FRANCIS AVE STE 204",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992056858",
            "telephone_number": "509-795-0988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 W FRANCIS AVE STE 204",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992056858",
            "telephone_number": "509-795-0988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JACQUELINE",
        "middle_name": "ROSE",
        "credential": "MA, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-25",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60945013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce C. Nelson, MSW, LICSW
• Emelie Nelson, LMHCA
• Erik James Nelson, PHARMD
• Grace Katharine Nelson
• Greg Nelson
• Jaime Ann Nelson, M.S., CCC-SLP
• James Douglas Nelson, MS
• Jane Nelson
• Jeffrey Edward Nelson, CRNA
• Jordan Nelson

• Mental Health Counselor in Spokane, WA
• Providers in Spokane, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.