Provider Demographics
NPI:1851624993
Name:DIXIE, CECELIA (MSW - LCSW)
Entity Type:Individual
Prefix:
First Name:CECELIA
Middle Name:
Last Name:DIXIE
Suffix:
Gender:F
Credentials:MSW - LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 STADIUM DR
Mailing Address - Street 2:APT. 210
Mailing Address - City:PHENIX CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36867-3184
Mailing Address - Country:US
Mailing Address - Phone:706-566-4602
Mailing Address - Fax:
Practice Address - Street 1:1700 CLAIRMONT RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-4032
Practice Address - Country:US
Practice Address - Phone:404-321-6111
Practice Address - Fax:404-929-5819
Is Sole Proprietor?:No
Enumeration Date:2009-09-08
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0051691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical