Sang Yun Nelson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.011055 Issued in IL

Practice address

2100 Madison Ave
Ste. 303
Granite City, IL 62040-4701

Phone

(618) 452-4969

NPI assigned

Nov 6, 2006

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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sang.yun.nelson.1@9559.direct.athenahealth.com

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.

• Southern Illinois Healthcare Foundation Inc

  • Federally Qualified Health Center (FQHC)
  • Centreville, IL
  • NPI 1609813500
  Medicare reassignment NPD
• Southern Illinois Healthcare Foundation Inc

  • Federally Qualified Health Center (FQHC)
  • Waterloo, IL
  • NPI 1821813247
  NPD
• Southern Illinois Healthcare Foundation, Inc

  • Federally Qualified Health Center (FQHC)
  • Alton, IL
  • NPI 1356377568
  NPD

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251763200000",
    "number": "1821177056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 STATE ST",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620023303",
            "telephone_number": "618-465-1263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 MADISON AVE",
            "address_2": "STE. 303",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620404701",
            "telephone_number": "618-452-4969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "SANG YUN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2009-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.011055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Multi-Care Specialists SC
• Ana Maria Murillo, DC
• Abubakarr Murray
• Amina Music, MMS, PA-C
• Sailor Myers, DC
• New Opportunities Inc.
• Todd Franklin Nichols
• Patricia Ann Northcutt, LCSW
• Timothy O'Connor, CRNA
• Old Six Mile Inpatient Services, LLC

• Clinical Social Worker in Granite City, IL
• Providers in Granite City, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.