| Carol L Nelson, Lcsw, Llc | |
|
8767 Seminole Trl Ste 201c Ruckersville VA 22968-3494 | |
| (434) 990-4163 | |
| (434) 990-4961 |
| Full Name | Carol L Nelson, Lcsw, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8767 Seminole Trl Ste 201c, Ruckersville, Virginia |
| Authorized Official Name and Position | Carol L Nelson (OWNER/PROVIDER) |
| Authorized Official Contact | 4349904163 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carol L Nelson, Lcsw, Llc 8767 Seminole Trl Ste 201c Ruckersville VA 22968-3494 Ph: (434) 990-4163 | Carol L Nelson, Lcsw, Llc 8767 Seminole Trl Ste 201c Ruckersville VA 22968-3494 Ph: (434) 990-4163 |
| NPI Number | 1841852423 |
|---|---|
| Provider Enumeration Date | 07/03/2019 |
| Last Update Date | 07/03/2019 |
| Medicare PECOS PAC ID | 2769717131 |
|---|---|
| Medicare Enrollment ID | O20190709000528 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841852423 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Carol L Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881914786 PECOS PAC ID: 2365778107 Enrollment ID: I20190731002319 |
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