Nelson, Shelly R

Nelson, Shelly R is an individual health care provider with primary practice located at 2825 N Mayfair Rd Suite 209, Wauwatosa WI 53222-4406. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Nelson, Shelly R can be contacted via phone (414) 630-1028.

Contact Information

Primary practice address
2825 N Mayfair Rd Suite 209 Wauwatosa WI 53222-4406
Phone: (414) 630-1028
Fax: (414) 256-0070
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 2620-120 Wisconsin
Behavioral Health & Social Service Providers / Professional 101YP2500X 3990-125 Wisconsin
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 16032-132 Wisconsin

Profile Details

NPI number 1346419561
LBN Legal business name Nelson, Shelly R
Credentials LPC, CSW, CSAC
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2008
Last updated Jan 20th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346419561 NPPES
Wisconsin MEDICAID 43731400

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