Provider Demographics
NPI:1912306507
Name:NELSON, BARBARA (LSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 DORSET CT
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-2188
Mailing Address - Country:US
Mailing Address - Phone:908-698-9164
Mailing Address - Fax:908-626-0050
Practice Address - Street 1:265 DORSET CT
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-2188
Practice Address - Country:US
Practice Address - Phone:908-698-9164
Practice Address - Fax:908-626-0050
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05972000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker