Provider Demographics
NPI:1871757054
Name:NELSON, GRETCHEN MARIE (MSW)
Entity type:Individual
Prefix:MRS
First Name:GRETCHEN
Middle Name:MARIE
Last Name:NELSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:GRETCHEN
Other - Middle Name:MARIE
Other - Last Name:WEBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LICSW
Mailing Address - Street 1:9120 SPRINGBROOK DRIVE NW
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433
Mailing Address - Country:US
Mailing Address - Phone:763-233-7270
Mailing Address - Fax:612-728-5301
Practice Address - Street 1:9120 SPRINGBROOK DRIVE NW
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433
Practice Address - Country:US
Practice Address - Phone:763-233-7270
Practice Address - Fax:612-728-5301
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical