Provider Demographics
NPI:1124509146
Name:NELSON, MARGARET THERESA (ACSW)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:THERESA
Last Name:NELSON
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 FREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-3224
Mailing Address - Country:US
Mailing Address - Phone:718-816-9075
Mailing Address - Fax:
Practice Address - Street 1:165 FREMONT AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-3224
Practice Address - Country:US
Practice Address - Phone:718-816-9075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty