Provider Demographics
NPI:1639381742
Name:NELSON, NANCY ELIZABETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:ELIZABETH
Last Name:NELSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 HEMLOCK LN
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6774
Mailing Address - Country:US
Mailing Address - Phone:973-538-5855
Mailing Address - Fax:
Practice Address - Street 1:58 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-5276
Practice Address - Country:US
Practice Address - Phone:973-538-5855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ#3033103TC1900X
NJ3033103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling