Keith Nelson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L3802 Issued in OR

Practice address

150 Kingwood Ave NW
Salem, OR 97304-4030

Phone

(503) 588-5816

Fax

(503) 588-5803

NPI assigned

Aug 31, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1023120086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 GOLDCREST AVE NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973042006",
            "telephone_number": "503-362-5083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 KINGWOOD AVE NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973044030",
            "telephone_number": "503-588-5816",
            "fax_number": "503-588-5803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KEITH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L3802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Nelson-Tripathi, LCSW
• Brock Jesse Nelson, DMD
• Jens Monroe Nelson
• Joel P Nelson, LPC
• Kathleen Nelson
• Lisa Nelson, RN
• Maren Nelson
• Morgan Nelson
• Rebecca Nelson
• Terry Lynn Nelson, RNFA

• Clinical Social Worker in Salem, OR
• Providers in Salem, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.