Provider Demographics
NPI:1679349104
Name:DIXON-BERISHA, ASHADENE ADEIKA (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:ASHADENE
Middle Name:ADEIKA
Last Name:DIXON-BERISHA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MISS
Other - First Name:ASHADENE
Other - Middle Name:ADEIKA
Other - Last Name:DIXON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:211 E 205TH ST APT 2A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-1200
Mailing Address - Country:US
Mailing Address - Phone:917-994-4509
Mailing Address - Fax:
Practice Address - Street 1:2488 GRAND CONCOURSE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-5203
Practice Address - Country:US
Practice Address - Phone:347-453-0961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP1260121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical