Nelson, Stacey Lynn
Nelson, Stacey Lynn is an individual health care provider with primary practice located at 19230 Evans St Nw Ste 109 , Elk River MN 55330-1079. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Nelson, Stacey Lynn can be contacted via phone (952) 213-5648.Contact Information
Primary practice address
19230 Evans St Nw Ste 109
Elk River MN 55330-1079
Phone: (952) 213-5648
Fax: (952) 213-5663
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | LP5661 | Minnesota |
Profile Details
| NPI number | 1760790828 |
|---|---|
| LBN Legal business name | Nelson, Stacey Lynn |
| Credentials | PSY.D |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 22nd, 2010 |
| Last updated | Dec 30th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760790828 | NPPES |
| Minnesota | MEDICAID | 943400400 | |
| Minnesota | Other | H400153967 |
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