Individual provider Active NPI

Charles Stephen Nisbet, LCSW

  • Social Worker
  • New York, NY
National Provider Identifier
1689839474
Registry record updated Feb 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
731 Lexington Ave
New York, NY 10022-1331
Phone
(212) 617-6170
NPI assigned
Jul 22, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 078694 NY
Social Worker 104100000X Primary

Addresses

Primary practice location

731 Lexington Ave
New York, NY 10022-1331

Mailing address

853 7TH Ave Apt 8F
New York, NY 10019-5222
Phone (646) 256-7238

Other practice location 1

853 7th Ave Apt 8F
New York, NY 10019-5222
Phone (646) 256-7238

Other identifiers 1

IdentifierTypeStateIssuer
03008151MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cnisbet@humana.com Direct

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

State licenses

LicenseStateTypeSpecialty
078694NYMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Arms Acres, Inc. PastSince Jan 1, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613347200000",
    "number": "1689839474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "853 7TH AVE APT 8F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100195222",
            "telephone_number": "646-256-7238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 LEXINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221331",
            "telephone_number": "212-617-6170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "853 7th Ave Apt 8F",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100195222",
            "country_code": "US",
            "telephone_number": "646-256-7238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NISBET",
        "first_name": "CHARLES",
        "middle_name": "STEPHEN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-22",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "078694",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03008151",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cnisbet@humana.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "clinical dates of service",
            "address_1": "853 7th Ave Apt 8F",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100195222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2021; 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.