Provider Demographics
NPI:1568980654
Name:NELSON, ELEANOR CRENSHAW (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELEANOR
Middle Name:CRENSHAW
Last Name:NELSON
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 1:1350 CONCOURSE AVE STE 142
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-4570
Mailing Address - Country:US
Mailing Address - Phone:901-701-2217
Mailing Address - Fax:
Practice Address - Street 1:1350 CONCOURSE AVE STE 142
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-4570
Practice Address - Country:US
Practice Address - Phone:901-701-2217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-08
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000064851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical