Provider Demographics
NPI:1386849743
Name:NELSEN, CARA L (LCSW)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:L
Last Name:NELSEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 CAROLINA ST SW
Mailing Address - Street 2:
Mailing Address - City:CALABASH
Mailing Address - State:NC
Mailing Address - Zip Code:28467-2212
Mailing Address - Country:US
Mailing Address - Phone:910-575-0881
Mailing Address - Fax:
Practice Address - Street 1:833 CAROLINA ST SW
Practice Address - Street 2:
Practice Address - City:CALABASH
Practice Address - State:NC
Practice Address - Zip Code:28467-2212
Practice Address - Country:US
Practice Address - Phone:910-575-0881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0595171041C0700X
NCC0050781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical