NPIMap

Individual provider Active NPI

Teresa Ann Nelson, M.ED.

  • Professional Counselor
  • Phoenix, AZ
National Provider Identifier
1962676767
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC.0011211 Issued in CO
Practice address
4220 N 20TH Ave
Phoenix, AZ 85015-5124
Phone
(602) 687-8219
Fax
(602) 889-9404
NPI assigned
Apr 14, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X LPC.0011211 CO Primary

Addresses

Primary practice location

4220 N 20TH Ave
Phoenix, AZ 85015-5124

Mailing address

2600 S. Parker Rd. Building 5 Suite 250
Aurora, CO 80014-5656

Other practice location 1

2600 S. Parker Rd. Building 5
Suite 250
Aurora, CO 80014-5656
Phone (303) 412-3890

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 Education

State licenses

LicenseStateTypeSpecialty
LPC.0011211COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Live Light Counseling, PLLC Mental Health Current Accepting new patients
Equality Medical Group LLC Past Accepting new patients
Your Neighborhood Healthcare Center LLC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1962676767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 S. PARKER RD. BUILDING 5 SUITE 250",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800145656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 N 20TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850155124",
            "telephone_number": "602-687-8219",
            "fax_number": "602-889-9404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2600 S. Parker Rd. Building 5",
            "address_2": "Suite 250",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800145656",
            "country_code": "US",
            "telephone_number": "303-412-3890",
            "fax_number": "303-412-3890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "TERESA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "M.ED.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-14",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0011211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.