Provider Demographics
NPI:1023151602
Name:LEHMAN, DIXIE L (DMIN)
Entity type:Individual
Prefix:DR
First Name:DIXIE
Middle Name:L
Last Name:LEHMAN
Suffix:
Gender:F
Credentials:DMIN
Other - Prefix:DR
Other - First Name:DIXIE
Other - Middle Name:POTRATZ
Other - Last Name:LEHMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMIN
Mailing Address - Street 1:1115 30TH AVE S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-6014
Mailing Address - Country:US
Mailing Address - Phone:701-297-3532
Mailing Address - Fax:701-235-6361
Practice Address - Street 1:1501 17TH AVE. S.
Practice Address - Street 2:FIRST BAPTIST CHURCH
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103
Practice Address - Country:US
Practice Address - Phone:701-235-6361
Practice Address - Fax:701-235-6361
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC723101YP2500X
SDLMFT1048106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional