Provider Demographics
NPI:1811232309
Name:NIXON, CARA LEIGH (PSYD)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:LEIGH
Last Name:NIXON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:CARA
Other - Middle Name:
Other - Last Name:NIXON BARBOSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:5660 STRAND CT
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-3343
Mailing Address - Country:US
Mailing Address - Phone:305-985-1114
Mailing Address - Fax:
Practice Address - Street 1:5660 STRAND CT
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-3343
Practice Address - Country:US
Practice Address - Phone:305-985-1114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-10
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9145103T00000X, 103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL021811400Medicaid