Individual
MR. CHARLES STEPHEN NISBET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
731 LEXINGTON AVE, NEW YORK, NY 10022-1331
(212) 617-6170
Mailing address
853 7TH AVE APT 8F, NEW YORK, NY 10019-5222
(646) 256-7238
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
078694
NY
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03008151
—
NY
Enumeration date
07/22/2008
Last updated
02/15/2021
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