Provider Demographics
NPI:1730328766
Name:NELSON, GARNET (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:GARNET
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4025
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20177-8198
Mailing Address - Country:US
Mailing Address - Phone:703-340-8936
Mailing Address - Fax:866-929-9306
Practice Address - Street 1:44330 PREMIER PLZ
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5070
Practice Address - Country:US
Practice Address - Phone:703-340-8936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-15
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD146041041C0700X
VA09040070671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical