Provider Demographics
NPI:1194932939
Name:NELSON, CURTIS L III (LCSW)
Entity type:Individual
Prefix:MR
First Name:CURTIS
Middle Name:L
Last Name:NELSON
Suffix:III
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2587
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201-2587
Mailing Address - Country:US
Mailing Address - Phone:502-451-3330
Mailing Address - Fax:
Practice Address - Street 1:4400 BRECKENRIDGE LN STE 125
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-4135
Practice Address - Country:US
Practice Address - Phone:502-472-4232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY35581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical