| Doctor Name: | LINDA NELSON |
| NPI Number: | 1134265705 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 078310 |
| Business Practice Address: | 116 Main St Penn Yan, NY - 145271806 |
| Business Phone Number: | 6073772354 |
| Business Fax Number: | 6072926810 |
| Mailing Address: | 14173 Keuka Village Rd, DUNDEE |
| State: | NY |
| Postal Code: | 148379621 |
| Phone Number: | 6073772354 |
| Fax Number: | 6072926810 |
| NPI Enumeration Date: | 01/30/2007 |
| NPI Last Update Date: | 11/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 078310 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |