Provider Demographics
NPI:1164093902
Name:NESBITT, JOONAH LUCY
Entity Type:Individual
Prefix:MRS
First Name:JOONAH
Middle Name:LUCY
Last Name:NESBITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7205 WINSLOW DR
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-8012
Mailing Address - Country:US
Mailing Address - Phone:704-261-6346
Mailing Address - Fax:
Practice Address - Street 1:212 LE PHILLIP CT NE STE 103
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-1901
Practice Address - Country:US
Practice Address - Phone:980-255-8745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-02
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health