Provider Demographics
NPI:1417282237
Name:NELSON, CHAD CAMERON (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:CAMERON
Last Name:NELSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 INTERNATIONAL CIR
Mailing Address - Street 2:SUITE 230
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21030-1304
Mailing Address - Country:US
Mailing Address - Phone:410-868-2076
Mailing Address - Fax:
Practice Address - Street 1:201 INTERNATIONAL CIR
Practice Address - Street 2:SUITE 230
Practice Address - City:HUNT VALLEY
Practice Address - State:MD
Practice Address - Zip Code:21030-1304
Practice Address - Country:US
Practice Address - Phone:410-868-2076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-13
Last Update Date:2016-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03366103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical