Provider Demographics
NPI:1689334443
Name:NESBIT, JIM (LBSW)
Entity Type:Individual
Prefix:
First Name:JIM
Middle Name:
Last Name:NESBIT
Suffix:
Gender:M
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 W GENESEE AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-3723
Mailing Address - Country:US
Mailing Address - Phone:989-799-1266
Mailing Address - Fax:989-799-1548
Practice Address - Street 1:2700 W GENESEE AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-3723
Practice Address - Country:US
Practice Address - Phone:989-799-1266
Practice Address - Fax:989-799-1548
Is Sole Proprietor?:No
Enumeration Date:2021-12-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802086188104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker