| Doctor Name: | DOUGLAS BRINKLEY NELSON |
| NPI Number: | 1023176146 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMHC |
| License Number: | 0701001944 |
| Business Practice Address: | 1881 Ne 26th St Suite 221 Wilton Manors, FL - 333051416 |
| Business Phone Number: | 9547899061 |
| Business Fax Number: | |
| Mailing Address: | 1881 Ne 26th St, Suite 221 WILTON MANORS |
| State: | FL |
| Postal Code: | 333051416 |
| Phone Number: | 9547899061 |
| Fax Number: | |
| NPI Enumeration Date: | 12/04/2006 |
| NPI Last Update Date: | 06/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 0701001944 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |