Individual provider Active NPI

Courtney Leak Nesbitt, LCSW

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1457698185
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C008285 Issued in NC
Practice address
3717 Latrobe Dr Ste 750
Charlotte, NC 28211-4826
Phone
(803) 493-9298
NPI assigned
Jan 15, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 10662 SC
Clinical Social Worker 1041C0700X C008285 NC Primary

Addresses

Primary practice location

3717 Latrobe Dr Ste 750
Charlotte, NC 28211-4826

Mailing address

6904 Murray Grey LN
Charlotte, NC 28273-3395
Phone (803) 493-9298

Other practice location 1

5200 Park Rd
Suite 219
Charlotte, NC 28209-3650
Phone (803) 493-9298

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1358208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1457698185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6904 MURRAY GREY LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282733395",
            "telephone_number": "803-493-9298",
            "fax_number": "866-384-4733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3717 LATROBE DR STE 750",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282114826",
            "telephone_number": "803-493-9298"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5200 Park Rd",
            "address_2": "Suite 219",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282093650",
            "country_code": "US",
            "telephone_number": "803-493-9298",
            "fax_number": "866-384-4733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NESBITT",
        "first_name": "COURTNEY",
        "middle_name": "LEAK",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-15",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "10662",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.