Provider Demographics
NPI:1730621855
Name:NELSON, DARLENE JULIETTE (SOCIAL WORK)
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:JULIETTE
Last Name:NELSON
Suffix:
Gender:F
Credentials:SOCIAL WORK
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8181 PROFESSIONAL PL STE 200
Mailing Address - Street 2:
Mailing Address - City:LANDOVER
Mailing Address - State:MD
Mailing Address - Zip Code:20785-7219
Mailing Address - Country:US
Mailing Address - Phone:301-306-4590
Mailing Address - Fax:
Practice Address - Street 1:8181 PROFESSIONAL PL STE 200
Practice Address - Street 2:
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-7219
Practice Address - Country:US
Practice Address - Phone:301-306-4590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-07
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC1144101Y00000X
DCLG101754104100000X
MD216321041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker