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NPI Code Detail

MEDICARE: MRS. ASHANIQUE ANNELL NELSON-CAVIL LCSW

MEDICARE:  MRS. ASHANIQUE ANNELL NELSON-CAVIL  LCSW
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 Counselor83263CA
21041C0700XClinical Social Worker103629CA
31041C0700XClinical Social WorkerCSW008997GA

General Provider Information

NPI Number : 1538684063
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ASHANIQUE ANNELL NELSON-CAVIL LCSW
Provider Business Mailing Address
First Line : 3393 SARDIS BEND DR
Second Line :
City : BUFORD
State : GA
Zip : 30519-6003
Country : US
Telephone Number : 510-918-2496
Fax Number :
Provider Business Practice Location Address
First Line : 3393 SARDIS BEND DR
Second Line :
City : BUFORD
State : GA
Zip : 30519-6003
Country : US
Telephone Number : 510-918-2496
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2017
Last Update Date : 03/30/2026

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Directions to “ MRS. ASHANIQUE ANNELL NELSON-CAVIL LCSW” Practice Location

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