Provider Demographics
NPI:1821233743
Name:MELLADO, NELSON FELIX (CADC)
Entity type:Individual
Prefix:MR
First Name:NELSON
Middle Name:FELIX
Last Name:MELLADO
Suffix:
Gender:M
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-1746
Mailing Address - Country:US
Mailing Address - Phone:319-351-9760
Mailing Address - Fax:
Practice Address - Street 1:220 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-1746
Practice Address - Country:US
Practice Address - Phone:319-351-9760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-05
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00087101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)