Provider Demographics
NPI:1427600261
Name:DIXON-THOMPSON, ANTOINETTE (LCSW, LCADC)
Entity Type:Individual
Prefix:MRS
First Name:ANTOINETTE
Middle Name:
Last Name:DIXON-THOMPSON
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4255 US HIGHWAY 9 BLDG 5B
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-8305
Mailing Address - Country:US
Mailing Address - Phone:609-901-3350
Mailing Address - Fax:609-901-3348
Practice Address - Street 1:4255 US HIGHWAY 9 BLDG 5B
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-8305
Practice Address - Country:US
Practice Address - Phone:609-901-3350
Practice Address - Fax:609-901-3348
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-11
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00297600101YA0400X
NJ44SC057716001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)