Provider Demographics
NPI:1184232795
Name:NELSON L HADLER, LLC
Entity type:Organization
Organization Name:NELSON L HADLER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:L
Authorized Official - Last Name:HADLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LCADC, CAC,
Authorized Official - Phone:973-713-7957
Mailing Address - Street 1:4118 NW 11TH TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33993-9144
Mailing Address - Country:US
Mailing Address - Phone:973-713-7957
Mailing Address - Fax:123-456-7990
Practice Address - Street 1:8192 COLLEGE PKWY STE B52
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-5179
Practice Address - Country:US
Practice Address - Phone:973-713-7957
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-20
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty