Individual provider Active NPI

Rebecca A Nelson, LSW

  • Clinical Social Worker
  • Danville, WV
National Provider Identifier
1407946874
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
AP00942191 Issued in WV
Practice address
376 Kenmore Drive
Danville, WV 25053
Phone
(304) 525-7851
Fax
(304) 525-1073
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X AP00942191 WV Primary

Addresses

Primary practice location

376 Kenmore Drive
Danville, WV 25053

Mailing address

3375 US RT 60 E
Huntington, WV 25705
Phone (304) 525-7851

Other identifiers 1

IdentifierTypeStateIssuer
AP0094191OtherWVLSW

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

State licenses

LicenseStateTypeSpecialty
AP00942191WVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Prestera Center for Mental Health Services Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407946874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3375 US RT 60 E",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "25705",
            "telephone_number": "304-525-7851",
            "fax_number": "304-525-1073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "376 KENMORE DRIVE",
            "city": "DANVILLE",
            "state": "WV",
            "postal_code": "25053",
            "telephone_number": "304-525-7851",
            "fax_number": "304-525-1073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "REBECCA",
        "middle_name": "A",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "AP00942191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LSW",
            "identifier": "AP0094191",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.