Active NPI
Nick Nelson, M.A.
- Marriage & Family Therapist
- Danbury, CT
National Provider Identifier
1003116484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 1793
- Practice address
- 75 West St
Danbury, CT 06810-6528 - Phone
- (203) 360-2889
- Fax
- (203) 332-3271
- NPI assigned
- Nov 1, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Marriage & Family Therapist | 106H00000X | MI0268 | NV | |
| Marriage & Family Therapist | 106H00000X | 1793 | CT | Primary |
Addresses
Primary practice location
75 West St
Danbury, CT 06810-6528
Mailing address
2660 North Ave
Unit 239
Bridgeport, CT 06604-2355
Phone (775) 250-8263
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MI0268 | NV | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468454400000",
"number": "1003116484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2660 NORTH AVE",
"address_2": "UNIT 239",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066042355",
"telephone_number": "775-250-8263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 WEST ST",
"city": "DANBURY",
"state": "CT",
"postal_code": "068106528",
"telephone_number": "203-360-2889",
"fax_number": "203-332-3271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "NICK",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-11-01",
"last_updated": "2016-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NV",
"license": "MI0268",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CT",
"license": "1793",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Danbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.