Wanda Ann Mixon, LGPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LGP10865 Issued in MD

Practice address

808 S 5TH Ave
Denton, MD 21629-1398

Phone

(410) 479-2650

Fax

(833) 908-2283

NPI assigned

Jan 10, 2022

Last updated

Jan 10, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1215688445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 S 5TH AVE",
            "city": "DENTON",
            "state": "MD",
            "postal_code": "216291398",
            "telephone_number": "410-479-2650",
            "fax_number": "833-908-2283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 S 5TH AVE",
            "city": "DENTON",
            "state": "MD",
            "postal_code": "216291398",
            "telephone_number": "410-479-2650",
            "fax_number": "833-908-2283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIXON",
        "first_name": "WANDA",
        "middle_name": "ANN",
        "credential": "LGPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-10",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LGP10865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caleb J McNiece, AU.D.
• Denise Maxine Mead, MS, CCC-SLP
• Adeline Lee Melvin, M.D.
• Tammy Lynn Merson, MSN, PMHNP-BC
• Raquel Elizabeth Millet, MD
• Sheri N Moore, DO
• Marissa Morrow, M.A., CCC-SLP
• Sarah Jane Muller, PHARMD
• Lindsay Madison Newcomb, LCSW-C
• Rodshekia Denise Newton

• Professional Counselor in Denton, MD
• Providers in Denton, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.