Provider Demographics
NPI:1619699741
Name:NIX, ELIZABETH (SW-C)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:NIX
Suffix:
Gender:F
Credentials:SW-C
Other - Prefix:
Other - First Name:E.B.
Other - Middle Name:
Other - Last Name:NIX
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SW-C
Mailing Address - Street 1:PO BOX 339
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81602-0339
Mailing Address - Country:US
Mailing Address - Phone:970-945-2840
Mailing Address - Fax:970-945-2893
Practice Address - Street 1:600 SOUTHSIDE DR
Practice Address - Street 2:
Practice Address - City:BASALT
Practice Address - State:CO
Practice Address - Zip Code:81621-9131
Practice Address - Country:US
Practice Address - Phone:970-945-2840
Practice Address - Fax:970-945-2893
Is Sole Proprietor?:No
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSWC.0000000652104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker