Provider Demographics
NPI:1376314104
Name:NIXON, JANICE
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:
Last Name:NIXON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 BROADWAY # EC1
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10570-2346
Mailing Address - Country:US
Mailing Address - Phone:914-771-6901
Mailing Address - Fax:
Practice Address - Street 1:820 BOYNTON AVE APT 5E
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-4617
Practice Address - Country:US
Practice Address - Phone:914-318-4383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional