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NPI Code Detail

MEDICARE: TESS NELSON

MEDICARE: TESS NELSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorPC019133PA

General Provider Information

NPI Number : 1023998804
Entity Type Code : Individual
Provider Name (Legal Business Name) : TESS NELSON
Provider Business Mailing Address
First Line : 142 CLIVEDEN AVE
Second Line :
City : GLENSIDE
State : PA
Zip : 19038-3502
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7301 GERMANTOWN AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19119-1726
Country : US
Telephone Number : 267-297-5170
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2025
Last Update Date : 09/03/2025

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Directions to “ TESS NELSON ” Practice Location

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