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NPI Code Detail

MEDICARE: CYNTHIA JOAN WIXON-LOECKER

MEDICARE: CYNTHIA JOAN WIXON-LOECKER
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 CounselorSD

General Provider Information

NPI Number : 1861323123
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNTHIA JOAN WIXON-LOECKER
Provider Business Mailing Address
First Line : 1942 FOX RD APT 103
Second Line :
City : RAPID CITY
State : SD
Zip : 57702-2267
Country : US
Telephone Number : 605-391-4863
Fax Number :
Provider Business Practice Location Address
First Line : 308 QUINCY ST
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-2813
Country : US
Telephone Number : 605-391-4863
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2026
Last Update Date : 05/26/2026

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Directions to “ CYNTHIA JOAN WIXON-LOECKER ” Practice Location

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