Provider Demographics
NPI:1114676368
Name:EPPOLITO, DIXIE (MS, LMHC)
Entity Type:Individual
Prefix:
First Name:DIXIE
Middle Name:
Last Name:EPPOLITO
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 NAVARRE SCHOOL RD UNIT 5277
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-6412
Mailing Address - Country:US
Mailing Address - Phone:850-684-5566
Mailing Address - Fax:850-546-4588
Practice Address - Street 1:8536 HIGH SCHOOL BLVD
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-3218
Practice Address - Country:US
Practice Address - Phone:850-684-5566
Practice Address - Fax:850-546-4588
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-23
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH16442101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health