Provider Demographics
NPI:1134472608
Name:NELSON, TRISHA NICOLE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:TRISHA
Middle Name:NICOLE
Last Name:NELSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:TRISHA
Other - Middle Name:NICOLE
Other - Last Name:TORRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:210 AVENUE C
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61832-5410
Mailing Address - Country:US
Mailing Address - Phone:217-442-3200
Mailing Address - Fax:217-442-7460
Practice Address - Street 1:210 AVENUE C
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-5410
Practice Address - Country:US
Practice Address - Phone:217-442-3200
Practice Address - Fax:217-442-7460
Is Sole Proprietor?:No
Enumeration Date:2012-10-22
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker