Healthcare Provider Details

I. General information

NPI: 1427929967
Provider Name (Legal Business Name): JOSHUA EDWARD NELSON MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 31ST ST
HUNTINGTON WV
25702-1420
US

IV. Provider business mailing address

1147 13TH ST
HUNTINGTON WV
25701-3634
US

V. Phone/Fax

Practice location:
  • Phone: 304-972-6767
  • Fax:
Mailing address:
  • Phone: 304-687-3961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW092517624
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: