Todd Michael Nelson, M.S., L.C.P.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180-003983 Issued in IL

Practice address

901 E Grove St
Suite T.
Bloomington, IL 61701-4200

Phone

(309) 532-3104

NPI assigned

Jan 17, 2007

Sex

Male

Sole proprietor

Yes

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486425600000",
    "number": "1073665501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E GROVE ST",
            "address_2": "SUITE R.",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617014200",
            "telephone_number": "309-532-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 E GROVE ST",
            "address_2": "SUITE T.",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617014200",
            "telephone_number": "309-532-3104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "TODD",
        "middle_name": "MICHAEL",
        "credential": "M.S., L.C.P.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2017-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180-003983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathy Jo Neitz
• Julia C Nelson White, LCPC, CRC
• Amy Lynn Nelson, OTR/L
• Haley Nelson
• Ryan C Nelson
• Alyssa N Nepereny
• Ashley Nero
• Margaret J Neumann, N.P.
• Stephanie Neumann
• Neurology Solutions

• Mental Health Counselor in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; 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.