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General NPI Number Information
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NPI Number | 1801972823
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Entity Type | Individual
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Provider Name | ADRIENNE NELSON LPC
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Gender | Female
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 03/26/2013
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Provider Practice Location Address
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Address Line | 329 MAIN RD
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City | MONTVILLE
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State | NJ
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Zip | 07045-9729
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Country | US
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Telephone | 917-881-6431
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Fax |
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Provider Business Mailing Address
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Address Line | 2 ROBERTSON WAY
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City | LINCOLN PARK
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State | NJ
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Zip | 07035-1826
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Country | US
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Telephone | 917-881-6431
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 18 002586
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00381800
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License Number State | NJ
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