Provider Demographics
NPI:1295052140
Name:NESBIT, PATRICIA RUTH (MS, LPC, LAT, NCC)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:RUTH
Last Name:NESBIT
Suffix:
Gender:F
Credentials:MS, LPC, LAT, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 S GILLETTE AVE
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-4205
Mailing Address - Country:US
Mailing Address - Phone:307-685-8182
Mailing Address - Fax:307-685-8183
Practice Address - Street 1:601 S GILLETTE AVE
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-4205
Practice Address - Country:US
Practice Address - Phone:307-685-8182
Practice Address - Fax:307-685-8183
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-30
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC 1146101Y00000X, 101YM0800X, 101YP2500X
WYLAT 321101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health