Healthcare Provider Details

I. General information

NPI: 1407710312
Provider Name (Legal Business Name): ALLISON NADINE NELSON LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 IRVING ST
VALLEY STREAM NY
11580-2234
US

IV. Provider business mailing address

8 IRVING ST
VALLEY STREAM NY
11580-2234
US

V. Phone/Fax

Practice location:
  • Phone: 347-869-0308
  • Fax:
Mailing address:
  • Phone: 347-869-0308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number129857-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: