Michael Dennis Nelson, S.U.D.C.C. III

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

03-097228 Issued in CA

Practice address

1601 Donner Ave Ste 3
San Francisco, CA 94124-3277

Phone

(415) 762-3700

Fax

(415) 865-0119

NPI assigned

Sep 6, 2011

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

Other identifiers 1

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.

• Center Point

  • Substance Abuse Rehabilitation Facility
  • San Rafael, CA
  • NPI 1093178279
  NPD (past)
• Healthright 360

  • Substance Use Disorder Rehabilitation Clinic/Center
  • San Francisco, CA
  • NPI 1417090341
  NPD (past)

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

{
    "created_epoch": "1315267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1578844486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1563 MISSION ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941032543",
            "telephone_number": "415-762-3700",
            "fax_number": "415-865-0119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 DONNER AVE STE 3",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941243277",
            "telephone_number": "415-762-3700",
            "fax_number": "415-865-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MICHAEL",
        "middle_name": "DENNIS",
        "name_prefix": "Mr.",
        "credential": "S.U.D.C.C. III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-06",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "03-097228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED COUNSELOR",
            "identifier": "101YA041X",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leticia Nelson
• Lisa Ingrid Nelson, NP
• Lyndsey Nelson
• Melyssa Vera Nelson, LMFT
• Michael Nelson
• Michelle Ho Nelson, RN
• Morgan Nelson, DDS
• Morgan Nelson, M.S. CCC-SLP
• Nancy Landers Nelson, PT
• Sally Nelson

• Addiction (Substance Use Disorder) Counselor in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; 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.