Provider Demographics
NPI:1750023511
Name:NIXON, MARCUS ANDREW
Entity Type:Individual
Prefix:
First Name:MARCUS
Middle Name:ANDREW
Last Name:NIXON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3927 INNER CIR
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:MD
Mailing Address - Zip Code:21225-2253
Mailing Address - Country:US
Mailing Address - Phone:443-860-1098
Mailing Address - Fax:
Practice Address - Street 1:1308 BUSINESS CENTER WAY STE 102
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:MD
Practice Address - Zip Code:21040-1504
Practice Address - Country:US
Practice Address - Phone:443-860-1098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)