Provider Demographics
NPI:1619331709
Name:NIXON, BASHIRA AISHA (MSW, LCSWA)
Entity Type:Individual
Prefix:MS
First Name:BASHIRA
Middle Name:AISHA
Last Name:NIXON
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 BAYER LN
Mailing Address - Street 2:APT. 2J
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27409-3452
Mailing Address - Country:US
Mailing Address - Phone:910-398-1227
Mailing Address - Fax:
Practice Address - Street 1:1325 S EUGENE ST
Practice Address - Street 2:C
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-1470
Practice Address - Country:US
Practice Address - Phone:336-294-5611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-05
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP009821101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health