Provider Demographics
NPI:1609181791
Name:DIXON, COLEEN ANNE (M ED, LPC)
Entity Type:Individual
Prefix:
First Name:COLEEN
Middle Name:ANNE
Last Name:DIXON
Suffix:
Gender:F
Credentials:M ED, 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 14
Mailing Address - Street 2:
Mailing Address - City:PHILIPSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16866-0014
Mailing Address - Country:US
Mailing Address - Phone:814-312-0647
Mailing Address - Fax:814-342-5347
Practice Address - Street 1:203 N FRONT ST
Practice Address - Street 2:SUITE 304
Practice Address - City:PHILIPSBURG
Practice Address - State:PA
Practice Address - Zip Code:16866-1647
Practice Address - Country:US
Practice Address - Phone:814-312-0647
Practice Address - Fax:814-342-5347
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor