Provider Demographics
NPI:1902159312
Name:BEAL-NELIS, EMILY A (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:A
Last Name:BEAL-NELIS
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7916 E 300 S
Mailing Address - Street 2:
Mailing Address - City:WALDRON
Mailing Address - State:IN
Mailing Address - Zip Code:46182-9557
Mailing Address - Country:US
Mailing Address - Phone:317-512-0230
Mailing Address - Fax:
Practice Address - Street 1:7916 E 300 S
Practice Address - Street 2:
Practice Address - City:WALDRON
Practice Address - State:IN
Practice Address - Zip Code:46182-9557
Practice Address - Country:US
Practice Address - Phone:317-512-0230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-23
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker