MEDICARE: MS. LINDA CHEWNING NELSON LCAS, LPC, CRC

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	952	NC

Other Identifiers

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

General Provider Information

NPI Number	:	1639374655
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDA CHEWNING NELSON LCAS, LPC, CRC

Provider Business Mailing Address
First Line	:	PO BOX 600
Second Line	:
City	:	SELMA
State	:	NC
Zip	:	27576-0600
Country	:	US
Telephone Number	:	919-965-6550
Fax Number	:	919-965-4443

Provider Business Practice Location Address
First Line	:	1101 RIVER RD
Second Line	:
City	:	SELMA
State	:	NC
Zip	:	27576-3611
Country	:	US
Telephone Number	:	919-965-6550
Fax Number	:	919-965-4443

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2007
Last Update Date	:	07/09/2007

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