Tracy Radig Nelson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3309 Issued in ND

Practice address

3911 20TH Ave S
Fargo, ND 58103-4705

Phone

(701) 271-3232

Fax

(701) 235-7359

NPI assigned

Oct 17, 2007

Sex

Female

Sole proprietor

No

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)

Enrolled

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.

• Prairie St Johns

  • Psychiatric Hospital
  • Fargo, ND
  • NPI 1417901000
  NPD (past)
• PSJ Acquisition LLC

  • Psychiatric Hospital
  • Fargo, ND
  • NPI 1679709802
  NPD (past)

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1649469461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 4TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031914",
            "telephone_number": "701-476-7200",
            "fax_number": "701-476-7261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 20TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034705",
            "telephone_number": "701-271-3232",
            "fax_number": "701-235-7359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 4th St S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581031914",
            "country_code": "US",
            "telephone_number": "701-476-7200",
            "fax_number": "701-476-7261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "TRACY",
        "middle_name": "RADIG",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-17",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "3309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Nelson, NP
• Stephen N Nelson, MD
• Susan Nelson
• Susan Nelson
• Susan Wolf Nelson, RPH
• Tyler Emma Nelson, MS CCC-SLP
• Crystal Nemer, RN
• Floyd Elias Nemer, CRNA
• Kimberley Nemeth-Garcia, OTR
• Kamal Nepali

• Clinical Social Worker in Fargo, ND
• Providers in Fargo, ND by specialty
• Clinical Social Worker in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; 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.