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General NPI Number Information
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NPI Number | 1528536539
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Entity Type | Organization
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Legal Business Name | HIXSON COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 11/07/2018
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Last Update Date | 02/15/2021
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Provider Practice Location Address
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Address Line | 270 W OAK ST STE 2
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-4813
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Country | US
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Telephone | 770-846-3220
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Fax | 770-995-1959
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Provider Business Mailing Address
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Address Line | 776 OXFORD CT SW
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City | LILBURN
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State | GA
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Zip | 30047-6563
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Country | US
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Telephone | 770-846-3220
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Fax | 770-995-1959
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Authorized Official
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Title or Position | OWNER
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Name | JOHN BENJAMIN HIXSON
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Credential | LPC
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Telephone | 770-846-3220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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