Provider Demographics
NPI:1134620487
Name:PRESCOTT, NANCY (LPCC)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:PRESCOTT
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 1:5000 W 36TH ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55416-2758
Mailing Address - Country:US
Mailing Address - Phone:651-269-4937
Mailing Address - Fax:
Practice Address - Street 1:5000 W 36TH ST # 207
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55416-2758
Practice Address - Country:US
Practice Address - Phone:651-269-4937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-22
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1685101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health