Provider Demographics
NPI:1437658887
Name:NELSON, HEATHER KAYE (LPCC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:KAYE
Last Name:NELSON
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 SOUTHTOWN BLVD STE 403
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-7407
Mailing Address - Country:US
Mailing Address - Phone:270-903-5151
Mailing Address - Fax:
Practice Address - Street 1:1215 SOUTHTOWN BLVD STE 403
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-7407
Practice Address - Country:US
Practice Address - Phone:270-903-5151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-12
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY261916101YP2500X
KY240041101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional