Provider Demographics
NPI:1013190057
Name:NIXON, WENDI DAWN (NCC, LPC)
Entity Type:Individual
Prefix:MRS
First Name:WENDI
Middle Name:DAWN
Last Name:NIXON
Suffix:
Gender:F
Credentials:NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2442
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27906-2442
Mailing Address - Country:US
Mailing Address - Phone:866-873-4173
Mailing Address - Fax:252-337-7514
Practice Address - Street 1:122 FOXBORO DR
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-7692
Practice Address - Country:US
Practice Address - Phone:866-873-4173
Practice Address - Fax:252-337-7514
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-13
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4201101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional