Provider Demographics
NPI:1356381495
Name:HIXSON, WILLIAM PAUL (LCSW-C)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:PAUL
Last Name:HIXSON
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 BROOKES AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-2799
Mailing Address - Country:US
Mailing Address - Phone:301-648-6109
Mailing Address - Fax:
Practice Address - Street 1:8 BROOKES AVE STE 203
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2799
Practice Address - Country:US
Practice Address - Phone:301-648-6109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD053761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD000761680OtherUNITED BEHAVIORAL HEALTH
DCCR78-0000OtherCAREFIRST BC/BS
MD2349757OtherCIGNA BEHAVIORAL HEALTH