Provider Demographics
NPI:1972945350
Name:NELSON, LAUREL EDELSON (MSW)
Entity Type:Individual
Prefix:MRS
First Name:LAUREL
Middle Name:EDELSON
Last Name:NELSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7019 OLD CABIN LN
Mailing Address - Street 2:
Mailing Address - City:NORTH BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4531
Mailing Address - Country:US
Mailing Address - Phone:301-984-1619
Mailing Address - Fax:301-231-7498
Practice Address - Street 1:7019 OLD CABIN LN
Practice Address - Street 2:
Practice Address - City:NORTH BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20852-4531
Practice Address - Country:US
Practice Address - Phone:301-984-1619
Practice Address - Fax:301-231-7498
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-25
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD021451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical