Healthcare Provider Details

I. General information

NPI: 1386849743
Provider Name (Legal Business Name): CARA L. NELSEN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 CAROLINA ST SW
CALABASH NC
28467-2212
US

IV. Provider business mailing address

PO BOX 135
BAT CAVE NC
28710-0135
US

V. Phone/Fax

Practice location:
  • Phone: 910-575-0881
  • Fax:
Mailing address:
  • Phone: 828-222-7949
  • Fax: 844-234-7856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC005078
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number059517
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: