=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558289629
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANA NELSON
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/07/2026
-----------------------------------------------------
Last Update Date | 07/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 55 WADE AVE
-----------------------------------------------------
City | CATONSVILLE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21228-4663
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-602-1598
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4462 WOODSMAN DR UNIT 421
-----------------------------------------------------
City | HAMPSTEAD
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21074-3114
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 13053
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------