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NPI Code Detail

MEDICARE: TED NELSON MSW,CSW

MEDICARE: TED NELSON MSW,CSW
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 Counselor13495LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073064556
Entity Type Code : Individual
Provider Name (Legal Business Name) : TED NELSON MSW,CSW
Provider Business Mailing Address
First Line : 2116 LAFRENIERE ST
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70122-3710
Country : US
Telephone Number : 504-610-1766
Fax Number :
Provider Business Practice Location Address
First Line : 2116 LAFRENIERE ST
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70122-3710
Country : US
Telephone Number : 504-610-1766
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2016
Last Update Date : 10/19/2016

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