Provider Demographics
NPI:1861023806
Name:NELSON, STEPHEN WILLIAM (MSW)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:WILLIAM
Last Name:NELSON
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-5067
Mailing Address - Country:US
Mailing Address - Phone:413-593-3078
Mailing Address - Fax:413-593-1978
Practice Address - Street 1:601 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-5067
Practice Address - Country:US
Practice Address - Phone:413-593-3078
Practice Address - Fax:413-593-1978
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty