Active NPI
Melissa Dawn Nelson, MA, LPC
- Professional Counselor
- Gilbert, AZ
National Provider Identifier
1720489354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-10764
- Practice address
- 2451 E Baseline Rd Ste 430
Gilbert, AZ 85234-2473 - Phone
- (480) 734-3851
- Fax
- (480) 623-0026
- NPI assigned
- Sep 15, 2014
- Last updated
- Sep 15, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-10764 | AZ | Primary |
Addresses
Primary practice location
2451 E Baseline Rd Ste 430
Gilbert, AZ 85234-2473
Mailing address
2451 E Baseline Rd
Gilbert, AZ 85234-2471
Phone (480) 734-3851
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 308968 | Medicaid | AZ |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-10764 | AZ | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Tan Behavioral Health Services LLC | Past | Accepting new patients | |
| San Tan Behavioral Health Services | Past | Accepting new patients |
Organizations & group practices 3
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410739200000",
"number": "1720489354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2451 E BASELINE RD",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852342471",
"telephone_number": "480-734-3851",
"fax_number": "480-623-0026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2451 E BASELINE RD STE 430",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852342473",
"telephone_number": "480-734-3851",
"fax_number": "480-623-0026"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "MELISSA",
"middle_name": "DAWN",
"name_prefix": "Mrs.",
"credential": "MA, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-15",
"last_updated": "2014-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LPC-10764",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "308968",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.