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NPI Code Detail

MEDICARE: ELIZABETH NIXON, LPC

MEDICARE: ELIZABETH NIXON, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor4625SC

General Provider Information

NPI Number : 1386980910
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELIZABETH NIXON, LPC
Provider Business Mailing Address
First Line : 4221 MAYFAIR ST
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29577-5757
Country : US
Telephone Number : 843-455-2258
Fax Number : 843-628-4909
Provider Business Practice Location Address
First Line : 4221 MAYFAIR ST
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29577-5757
Country : US
Telephone Number : 843-455-2258
Fax Number : 843-628-4909
Authorized Official
Title or Position : COUNSELOR
Name : MS. ELIZABETH R NIXON
Credential : LPC, LPC/S
Telephone Number : 843-455-2258
Provider Enumeration Date : 01/01/2013
Last Update Date : 01/01/2013

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