Provider Demographics
NPI:1891851796
Name:NELSON, JOAN F (LCSW-C)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:F
Last Name:NELSON
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 KATE WAGNER RD.
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157
Mailing Address - Country:US
Mailing Address - Phone:410-848-2500
Mailing Address - Fax:410-876-3016
Practice Address - Street 1:59 KATE WAGNER RD.
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157
Practice Address - Country:US
Practice Address - Phone:410-848-2500
Practice Address - Fax:410-876-3016
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD075401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD615501400Medicaid