Individual
EBONY NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14631 IRVING AVE, DOLTON, IL 60419-2027
(312) 366-1458
Mailing address
14631 IRVING AVE, DOLTON, IL 60419-2027
(312) 366-1458
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
150.129038
IL
104100000X
Social Worker
Primary
150.129038
IL
Other
Enumeration date
04/24/2026
Last updated
04/30/2026
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