Provider Demographics
NPI:1417106550
Name:DIXON, NICOLE M (LPC)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:M
Last Name:DIXON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 602373
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2373
Mailing Address - Country:US
Mailing Address - Phone:828-213-1500
Mailing Address - Fax:828-651-6570
Practice Address - Street 1:501 BILTMORE AVE
Practice Address - Street 2:SUITE G276.10
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4601
Practice Address - Country:US
Practice Address - Phone:828-213-4502
Practice Address - Fax:828-213-4540
Is Sole Proprietor?:No
Enumeration Date:2008-09-12
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0085161101YA0400X
NC11391101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)