Provider Demographics
NPI:1770195133
Name:NELSON, JOYCE (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:PO BOX 3068
Mailing Address - Street 2:
Mailing Address - City:BALD HEAD ISLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28461-7000
Mailing Address - Country:US
Mailing Address - Phone:240-418-3505
Mailing Address - Fax:
Practice Address - Street 1:6 WIDGEON CT
Practice Address - Street 2:
Practice Address - City:BALD HEAD ISLAND
Practice Address - State:NC
Practice Address - Zip Code:28461-5126
Practice Address - Country:US
Practice Address - Phone:240-418-3505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD099501041C0700X
NCC0082251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical