Provider Demographics
NPI:1851542146
Name:NELSON, MELISSA A (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:A
Last Name:NELSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 VEAZEY ROAD
Mailing Address - Street 2:CENTRAL REGIONAL HOSPITAL
Mailing Address - City:BUTNER
Mailing Address - State:NC
Mailing Address - Zip Code:27509
Mailing Address - Country:US
Mailing Address - Phone:919-764-2000
Mailing Address - Fax:919-764-7238
Practice Address - Street 1:300 VEAZEY ROAD
Practice Address - Street 2:CENTRAL REGIONAL HOSPITAL
Practice Address - City:BUTNER
Practice Address - State:NC
Practice Address - Zip Code:27509
Practice Address - Country:US
Practice Address - Phone:919-764-2000
Practice Address - Fax:919-764-7238
Is Sole Proprietor?:No
Enumeration Date:2008-10-05
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0047581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical