Provider Demographics
NPI:1093133852
Name:BIXLER, MAUREEN SULLIVAN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:SULLIVAN
Last Name:BIXLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6424 BLUE WATER DR
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-7253
Mailing Address - Country:US
Mailing Address - Phone:404-432-2113
Mailing Address - Fax:
Practice Address - Street 1:6424 BLUE WATER DR
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-7253
Practice Address - Country:US
Practice Address - Phone:404-432-2113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-30
Last Update Date:2014-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0043941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical