Provider Demographics
NPI:1578644092
Name:NIXA COUNSELING CENTER, INC
Entity Type:Organization
Organization Name:NIXA COUNSELING CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:GRITZMACHER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:417-725-8922
Mailing Address - Street 1:PO BOX 927
Mailing Address - Street 2:
Mailing Address - City:NIXA
Mailing Address - State:MO
Mailing Address - Zip Code:65714-0927
Mailing Address - Country:US
Mailing Address - Phone:417-725-8922
Mailing Address - Fax:417-725-8983
Practice Address - Street 1:214 VILLAGE CENTER
Practice Address - Street 2:B
Practice Address - City:NIXA
Practice Address - State:MO
Practice Address - Zip Code:65714-0927
Practice Address - Country:US
Practice Address - Phone:417-725-8922
Practice Address - Fax:417-725-8983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR0454103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty