Provider Demographics
NPI:1912899782
Name:NELSON, TRINITY ELISE
Entity type:Individual
Prefix:
First Name:TRINITY
Middle Name:ELISE
Last Name:NELSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 W MELROSE ST APT 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-3220
Mailing Address - Country:US
Mailing Address - Phone:224-678-6648
Mailing Address - Fax:
Practice Address - Street 1:30 N MICHIGAN AVE STE 809
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3776
Practice Address - Country:US
Practice Address - Phone:312-767-2057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist