Shelly R Nelson, LPC, CSW, CSAC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3990-125 Issued in WI

Practice address

2825 N Mayfair Rd
Suite 209
Wauwatosa, WI 53222-4406

Phone

(414) 630-1028

Fax

(414) 256-0070

NPI assigned

Feb 21, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Shelly Hodson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Empower Counseling of Milwaukee, LLC

  • Clinical Psychologist
  • Wauwatosa, WI
  • NPI 1386473015
  NPD (past)

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

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484870400000",
    "number": "1346419561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 N MAYFAIR RD STE 209",
            "address_2": "SUITE 209",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532224406",
            "telephone_number": "414-630-1028",
            "fax_number": "414-256-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 N MAYFAIR RD",
            "address_2": "SUITE 209",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532224406",
            "telephone_number": "414-630-1028",
            "fax_number": "414-256-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "SHELLY",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "LPC, CSW, CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-21",
        "last_updated": "2017-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "2620-120",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3990-125",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16032-132",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43731400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLY",
            "last_name": "HODSON",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sarah Neller
• Katharine Nelson Suwalski, DDS
• Anthony Carl Nelson, M.D.
• Melvin Ruthford Nelson, PHD
• Patricia Kay Nelson, APNP
• Stephanie Kristina Nelson, RN, IBCLC
• Mary Ziemer Nervig, LCSW
• Mary E. Ness, M.D.
• Neu Family Dentistry, S.C.
• Suzanne M Neumann, AUD.

• Professional Counselor in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Professional Counselor in Wisconsin

• 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.