Provider Demographics
NPI:1508904806
Name:NIX, ORVIE (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ORVIE
Middle Name:
Last Name:NIX
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 1:6300 W INTERSTATE 40
Mailing Address - Street 2:110
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-2523
Mailing Address - Country:US
Mailing Address - Phone:806-356-6561
Mailing Address - Fax:806-356-6567
Practice Address - Street 1:6300 W INTERSTATE 40
Practice Address - Street 2:110
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2523
Practice Address - Country:US
Practice Address - Phone:806-356-6561
Practice Address - Fax:806-356-6567
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS195471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0003DZOtherBLUECROSSBLUESHIELD