Provider Demographics
NPI:1891149035
Name:NESBIT, KERRY (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:KERRY
Middle Name:
Last Name:NESBIT
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 PARLANGE DR
Mailing Address - Street 2:
Mailing Address - City:DESTREHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70047-2133
Mailing Address - Country:US
Mailing Address - Phone:504-388-4135
Mailing Address - Fax:
Practice Address - Street 1:61 PARLANGE DR
Practice Address - Street 2:
Practice Address - City:DESTREHAN
Practice Address - State:LA
Practice Address - Zip Code:70047-2133
Practice Address - Country:US
Practice Address - Phone:504-388-4135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-13
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5532101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional