Provider Demographics
NPI:1619339074
Name:DIXON, KATRINA SUE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:SUE
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 1:7570 BALES ST # 380
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45069-7516
Mailing Address - Country:US
Mailing Address - Phone:513-924-4953
Mailing Address - Fax:
Practice Address - Street 1:8904 BROOKSIDE AVE
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-3139
Practice Address - Country:US
Practice Address - Phone:513-644-1030
Practice Address - Fax:513-644-1025
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-24
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1700287101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health