Provider Demographics
NPI:1235323866
Name:NIXON, LAINA CATHARINE-MARIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LAINA
Middle Name:CATHARINE-MARIE
Last Name:NIXON
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 1:332 MAIN ST
Mailing Address - Street 2:SUITE 320
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1517
Mailing Address - Country:US
Mailing Address - Phone:508-732-3969
Mailing Address - Fax:
Practice Address - Street 1:332 MAIN ST
Practice Address - Street 2:SUITE 320
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1517
Practice Address - Country:US
Practice Address - Phone:508-732-3969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA214515101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health