Provider Demographics
NPI:1700427051
Name:NESBITT, JEFFREY (LSW)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:NESBITT
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 ASHBY RD
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-3128
Mailing Address - Country:US
Mailing Address - Phone:267-269-8140
Mailing Address - Fax:267-269-8140
Practice Address - Street 1:155 ASHBY RD
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-3128
Practice Address - Country:US
Practice Address - Phone:267-269-8140
Practice Address - Fax:267-269-8140
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-07
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW136448104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker