Provider Demographics
NPI:1578639217
Name:NELSON, CYLA M (LCSW CADC)
Entity Type:Individual
Prefix:MS
First Name:CYLA
Middle Name:M
Last Name:NELSON
Suffix:
Gender:F
Credentials:LCSW CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1161 FILBERT AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926
Mailing Address - Country:US
Mailing Address - Phone:530-343-9186
Mailing Address - Fax:
Practice Address - Street 1:2430 BIRD STREET
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965
Practice Address - Country:US
Practice Address - Phone:530-538-7277
Practice Address - Fax:530-538-7315
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CALCS184811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALCS18481OtherBBS