Individual provider Active NPI

David Mann Nixon, LCSW, DMHP

  • Clinical Social Worker
  • Chehalis, WA
National Provider Identifier
1154863116
Registry record updated Jun 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
60492662 Issued in WA
Practice address
2690 NE Kresky Ave
Chehalis, WA 98532
Phone
(360) 330-9595
Fax
(360) 330-9560
NPI assigned
Nov 8, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 60492662 WA Primary

Addresses

Primary practice location

2690 NE Kresky Ave
Chehalis, WA 98532

Mailing address

3285 Ferguson St SW
Tumwater, WA 98512-6192
Phone (360) 943-1907

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60492662WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Clear Insights Therapy LLC Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1478563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528156800000",
    "number": "1154863116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3285 FERGUSON ST SW",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985126192",
            "telephone_number": "360-943-1907",
            "fax_number": "360-943-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2690 NE KRESKY AVE",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "98532",
            "telephone_number": "360-330-9595",
            "fax_number": "360-330-9560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIXON",
        "first_name": "DAVID",
        "middle_name": "MANN",
        "name_prefix": "Mr.",
        "credential": "LCSW, DMHP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-08",
        "last_updated": "2018-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "60492662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chehalis, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.