Provider Demographics
NPI:1780862045
Name:ELIZABETH J. DIXON, LLC
Entity Type:Organization
Organization Name:ELIZABETH J. DIXON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:843-345-8397
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4700101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty