Provider Demographics
NPI:1407895808
Name:NESBITT COUNSELING & CLINICAL SERVICES, INC.
Entity Type:Organization
Organization Name:NESBITT COUNSELING & CLINICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ZAKIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:NESBITT
Authorized Official - Suffix:
Authorized Official - Credentials:MS, NCC, LPC
Authorized Official - Phone:336-398-4473
Mailing Address - Street 1:2021 HERON PT
Mailing Address - Street 2:
Mailing Address - City:WHITSETT
Mailing Address - State:NC
Mailing Address - Zip Code:27377-9341
Mailing Address - Country:US
Mailing Address - Phone:336-398-4473
Mailing Address - Fax:
Practice Address - Street 1:2021 HERON PT
Practice Address - Street 2:
Practice Address - City:WHITSETT
Practice Address - State:NC
Practice Address - Zip Code:27377-9341
Practice Address - Country:US
Practice Address - Phone:336-398-4473
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5164101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103022Medicaid