Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Addy Nelson, LSW

Individual provider Professional Counselor · NPI 1063937472

Addy Nelson, LSW is a Mental Health Counselor in Fargo, North Dakota. Qualified in 2017, 9 years ago. Practices with Southeast Human Service Center, a 29-clinician group and accepts Medicare assignment. Licensed in North Dakota.

Years since qualifying
9
Licensed in
ND
In the registry since
2017
Specialties on file
4
What do these letters mean?
LSW — Licensed Social Worker
A state-licensed social worker.

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Practice location Address checks out

2624 9th Ave S
Fargo, ND 58103-2350
Phone: (701) 298-4500
Fax: (701) 298-4400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 1821 (ND)
Professional Counselor Taxonomy 101YP2500X · Licence 1038-11-1-19A (ND)
Social Worker Taxonomy 104100000X · Licence 4835 (ND)
Case Manager/Care Coordinator Taxonomy 171M00000X

Record details

NPI number1063937472
Entity typeIndividual (Type 1)
GenderFemale
Credentials LSW
Sole proprietorNo
NPI enumeratedAugust 7, 2017
Last updated in NPPESJuly 21, 2022
Certification dateJanuary 28, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Southeast Human Service Center — 29 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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