Provider Demographics
NPI:1134472608
Name:NELSON, TRISHA NICOLE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:TRISHA
Middle Name:NICOLE
Last Name:NELSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:TRISHA
Other - Middle Name:NICOLE
Other - Last Name:TORRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:2125 S NEIL ST
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61820-7266
Mailing Address - Country:US
Mailing Address - Phone:217-352-0200
Mailing Address - Fax:217-607-1139
Practice Address - Street 1:116 S LOMBARD ST
Practice Address - Street 2:
Practice Address - City:MAHOMET
Practice Address - State:IL
Practice Address - Zip Code:61853-9202
Practice Address - Country:US
Practice Address - Phone:217-352-0200
Practice Address - Fax:217-607-1139
Is Sole Proprietor?:No
Enumeration Date:2012-10-22
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0160731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical