Nelson Family Counseling, LLC.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149009316 Issued in IL

Legal business name

NELSON FAMILY COUNSELING, LLC.

Practice address

705 E Lincoln St Ste 302
Normal, IL 61761-6406

Phone

(309) 826-3566

Fax

(309) 452-9814

NPI assigned

Jan 20, 2017

Last updated

Jan 20, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Katharine Ann Fagan-Nelson, LCSWNPI 1578953915

Title

Licensced Clinical Social Worker

Phone

(309) 826-3566

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Katharine Fagan-Nelson, LCSW

  • Clinical Social Worker
  • Bloomington, IL
  • NPI 1578953915
  NPD (past) Authorized official

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

{
    "created_epoch": "1484870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484870400000",
    "number": "1114464781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 E LINCOLN ST STE 302",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617616406",
            "telephone_number": "309-826-3566",
            "fax_number": "309-452-9814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 E LINCOLN ST STE 302",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617616406",
            "telephone_number": "309-826-3566",
            "fax_number": "309-452-9814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NELSON FAMILY COUNSELING, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-20",
        "last_updated": "2017-01-20",
        "status": "A",
        "authorized_official_last_name": "FAGAN-NELSON",
        "authorized_official_first_name": "KATHARINE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "LICENSCED  CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "309-826-3566",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149009316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Normal, IL
• Providers in Normal, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 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.