Provider Demographics
NPI:1568746832
Name:HIXON, REBEKKAH L (BA, CADC)
Entity Type:Individual
Prefix:MISS
First Name:REBEKKAH
Middle Name:L
Last Name:HIXON
Suffix:
Gender:F
Credentials:BA, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 MICAH DR
Mailing Address - Street 2:DRAWER M
Mailing Address - City:OLNEY
Mailing Address - State:IL
Mailing Address - Zip Code:62450-4720
Mailing Address - Country:US
Mailing Address - Phone:618-395-4506
Mailing Address - Fax:618-395-4507
Practice Address - Street 1:1501 OLIVE ST
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62439-2269
Practice Address - Country:US
Practice Address - Phone:618-943-3451
Practice Address - Fax:618-943-4368
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health