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General NPI Number Information
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NPI Number | 1346974821
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Entity Type | Individual
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Provider Name | SYDNEY NICOLE NELSON MSW, LSW
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Gender | Female
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Dates
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Enumeration Date | 07/12/2022
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 600 N JACKSON ST
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City | MEDIA
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State | PA
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Zip | 19063-2561
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Country | US
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Telephone | 484-442-0073
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Fax |
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Provider Business Mailing Address
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Address Line | 36 W BERKLEY AVE
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City | CLIFTON HEIGHTS
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State | PA
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Zip | 19018-2503
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Country | US
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Telephone | 484-804-0058
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW140771
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License Number State | PA
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