Active NPI
Stacy Lynn Nelson
- Counselor
- Henderson, NV
National Provider Identifier
1821535162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- CI620
- Practice address
- 2501 N Green Valley Pkwy Ste 116
Henderson, NV 89014-2158 - Phone
- (702) 938-5096
- NPI assigned
- Jan 25, 2017
- Last updated
- Jan 25, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | CI620 | NV | Primary |
Addresses
Primary practice location
2501 N Green Valley Pkwy Ste 116
Henderson, NV 89014-2158
Mailing address
2501 N. Green Valley Parkway
BLDG D Suite 116-118
Henderson, NV 89014
Phone (702) 605-2766
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 |
|---|---|---|---|
| CI620 | NV | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548374400000",
"number": "1821535162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2501 N. GREEN VALLEY PARKWAY",
"address_2": "BLDG D SUITE 116-118",
"city": "HENDERSON",
"state": "NV",
"postal_code": "89014",
"telephone_number": "702-605-2766",
"fax_number": "702-938-9056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 N GREEN VALLEY PKWY STE 116",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890142158",
"telephone_number": "702-938-5096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "STACY",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-01-25",
"last_updated": "2019-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NV",
"license": "CI620",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.