| Tm Nelson: Counseling & Wellness, Llc | |
|
4801 W Peterson Ave Ste 305 Chicago IL 60646-5726 | |
| (312) 576-0127 | |
| Not Available |
| Full Name | Tm Nelson: Counseling & Wellness, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4801 W Peterson Ave Ste 305, Chicago, Illinois |
| Authorized Official Name and Position | Todd M Nelson (THERAPIST/SOCIAL WORKER) |
| Authorized Official Contact | 3125760127 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tm Nelson: Counseling & Wellness, Llc 1529 W Farwell Ave Apt 3s Chicago IL 60626-3657 Ph: (312) 576-0127 | Tm Nelson: Counseling & Wellness, Llc 4801 W Peterson Ave Ste 305 Chicago IL 60646-5726 Ph: (312) 576-0127 |
| NPI Number | 1710601067 |
|---|---|
| Provider Enumeration Date | 09/30/2022 |
| Last Update Date | 01/27/2023 |
| Certification Date | 01/27/2023 |
| Medicare PECOS PAC ID | 9234584384 |
|---|---|
| Medicare Enrollment ID | O20231010003795 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710601067 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Todd Myron Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528376100 PECOS PAC ID: 0143675298 Enrollment ID: I20231010003833 |
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