Provider Demographics
NPI:1578766960
Name:DIXON, DAVID CALDWELL (LPC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:CALDWELL
Last Name:DIXON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 FARM RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-7889
Mailing Address - Country:US
Mailing Address - Phone:704-843-7591
Mailing Address - Fax:
Practice Address - Street 1:1145 PINEVILLE MATTHEWS RD
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-6518
Practice Address - Country:US
Practice Address - Phone:704-849-0686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2789101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional