Nancy Jayne Nelson, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

149.006567 Issued in IL

Practice address

4509 E Sherrill Rd
Minooka, IL 60447-9873

Phone

(815) 405-3559

NPI assigned

Mar 20, 2017

Last updated

Mar 20, 2017By the provider in NPPES

Sex

Female

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

State licenses

Practice roles

Locations

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

• Aspire-Center for Positive Change

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Channahon, IL
  • NPI 1942811989
  NPD Authorized official
• Aspire Therapy Center

  • Mental Health Counselor
  • Channahon, IL
  • NPI 1336902022
  NPD (past)

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1548701758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4509 E SHERRILL RD",
            "city": "MINOOKA",
            "state": "IL",
            "postal_code": "604479873",
            "telephone_number": "815-405-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4509 E SHERRILL RD",
            "city": "MINOOKA",
            "state": "IL",
            "postal_code": "604479873",
            "telephone_number": "815-405-3559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "NANCY",
        "middle_name": "JAYNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-20",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "149.006567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Melissa E Porfirio

• Social Worker in Minooka, IL
• Providers in Minooka, IL by specialty
• Social Worker in Illinois

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