Active NPI
Georgia A Nelson, LPC
- Mental Health Counselor
- Carefree, AZ
National Provider Identifier
1689756355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 14576
- Practice address
- 36600 N Pima Rd
Suite 203
Carefree, AZ 85377 - Phone
- (402) 617-0450
- Fax
- (480) 203-2190
- NPI assigned
- Oct 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 2058 | NE | |
| Mental Health Counselor | 101YM0800X | 14576 | AZ | Primary |
Addresses
Primary practice location
36600 N Pima Rd
Suite 203
Carefree, AZ 85377
Mailing address
PO Box 27272
Scottsdale, AZ 85255-0137
Phone (402) 617-0450
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36008 | Other | NE | MIDLANDS CHOICE |
| 47083791626 | Medicaid | NE | |
| 84282 | Other | NE | BLUE CROSS/BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2058 | NE | MD | Addiction (Substance Use Disorder) Counselor |
| 14576 | AZ | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407369600000",
"number": "1689756355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27272",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852550137",
"telephone_number": "402-617-0450",
"fax_number": "480-203-2190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36600 N PIMA RD",
"address_2": "SUITE 203",
"city": "CAREFREE",
"state": "AZ",
"postal_code": "85377",
"telephone_number": "402-617-0450",
"fax_number": "480-203-2190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "GEORGIA",
"middle_name": "A",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-20",
"last_updated": "2014-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NE",
"license": "2058",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AZ",
"license": "14576",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDLANDS CHOICE",
"identifier": "36008",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47083791626",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "84282",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carefree, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.