Provider Demographics
NPI:1013668474
Name:NELSON, NATALI
Entity Type:Individual
Prefix:
First Name:NATALI
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1760 LAKES PKWY
Mailing Address - Street 2:UNIT 4416
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-6194
Mailing Address - Country:US
Mailing Address - Phone:413-427-3627
Mailing Address - Fax:
Practice Address - Street 1:1760 LAKES PKWY UNIT 4416
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-6194
Practice Address - Country:US
Practice Address - Phone:413-427-3627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-17
Last Update Date:2023-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical