Individual
GARY L NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
14301 COUNTY HIGHWAY B, SPARTA, WI 54656-4509
(608) 269-8654
Mailing address
14301 COUNTY HIGHWAY B, SPARTA, WI 54656-4509
(608) 269-8654
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
12319
WI
101YM0800X
Mental Health Counselor
Primary
1345-123
WI
Other
Enumeration date
04/10/2007
Last updated
09/11/2025
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