Active NPI
Andre Mixon, BSW,MSW,LMSW
- Clinical Social Worker
- Tucson, AZ
National Provider Identifier
1821453085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 15416
- Practice address
- 7490 S Camino de Oeste
Tucson, AZ 85746-9308 - Phone
- (520) 879-5909
- NPI assigned
- Dec 15, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 15416 | AZ | Primary |
Addresses
Primary practice location
7490 S Camino de Oeste
Tucson, AZ 85746-9308
Mailing address
7490 S Camino de Oeste
Tucson, AZ 85746-9308
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15416 | AZ | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1450137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450137600000",
"number": "1821453085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7490 S CAMINO DE OESTE",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857469308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7490 S CAMINO DE OESTE",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857469308",
"telephone_number": "520-879-5909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIXON",
"first_name": "ANDRE",
"name_prefix": "Mr.",
"credential": "BSW,MSW,LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-12-15",
"last_updated": "2015-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AZ",
"license": "15416",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.