Provider Demographics
NPI:1659549723
Name:WALKER DIXON, ELIZABETH J (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:J
Last Name:WALKER 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 1:1546 CLARK SOUND CIR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-8431
Mailing Address - Country:US
Mailing Address - Phone:843-345-8397
Mailing Address - Fax:
Practice Address - Street 1:792 FOLLY RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-3476
Practice Address - Country:US
Practice Address - Phone:843-345-8397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4700101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional