Provider Demographics
NPI:1770750697
Name:NESBIT, ALAN DAVID (LCSW)
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:DAVID
Last Name:NESBIT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19742 E ARROWHEAD TRL
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-8663
Mailing Address - Country:US
Mailing Address - Phone:480-745-5552
Mailing Address - Fax:
Practice Address - Street 1:1166 E WARNER RD
Practice Address - Street 2:SUITE 101-L
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-3064
Practice Address - Country:US
Practice Address - Phone:480-745-5552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ130461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical