Provider Demographics
NPI:1457828048
Name:PRISBY, NANCY LEE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:LEE
Last Name:PRISBY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37899 W 12 MILE RD STE 250
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-6107
Mailing Address - Country:US
Mailing Address - Phone:248-939-8500
Mailing Address - Fax:
Practice Address - Street 1:25921 LARAMIE DR
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48374-2369
Practice Address - Country:US
Practice Address - Phone:248-321-2767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-01
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010931631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical