Provider Demographics
NPI:1033134077
Name:RICHARDS, DIXIE LOVE (MA, LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:DIXIE
Middle Name:LOVE
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:MA, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 SOUTHFIELD RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-4130
Mailing Address - Country:US
Mailing Address - Phone:318-861-0862
Mailing Address - Fax:318-861-0864
Practice Address - Street 1:321 SOUTHFIELD RD
Practice Address - Street 2:SUITE 104
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-4130
Practice Address - Country:US
Practice Address - Phone:318-861-0862
Practice Address - Fax:318-861-0864
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1827101YM0800X
LA540106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist