MICHAEL JAN NELSON PHD NPI 1205097870

NPI Information

  • NPI: 1205097870
  • Provider Name: MICHAEL JAN NELSON PHD
  • Classification: Community/Behavioral Health - 251S00000X
  • Entity Type: Organization
  • Doing Business As: CLINICAL SERVICES
  • Address: 420 1ST AVE S
    WISCONSIN RAPIDS, WI
    ZIP 54495
  • Phone: (715) 424-3400

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NPI Details

MICHAEL JAN NELSON PHD is a community behavioral health in Wisconsin Rapids, WI. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. MICHAEL JAN NELSON PHD NPI is 1205097870. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Clinical Services.

The provider's business location address is:

420 1ST AVE S
WISCONSIN RAPIDS, WI
ZIP 54495
Phone: (715) 424-3400
Fax: (715) 424-3441

The provider's authorized official is Julie A Sigler Edmundson .
The authorized official title is Administrator and has the following contact phone number (715) 712-1370.

The enumeration date for this NPI number is 6/17/2008 and was last updated on 8/29/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TC0700XPsychologistClinicalNo
2251S00000XCommunity/Behavioral Health1298WISCONSINYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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