Provider Demographics
NPI:1336884253
Name:DIXON, LAWSON DAVIS (MA, LCMHCA)
Entity Type:Individual
Prefix:
First Name:LAWSON
Middle Name:DAVIS
Last Name:DIXON
Suffix:
Gender:F
Credentials:MA, LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 JADE LN
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-4401
Mailing Address - Country:US
Mailing Address - Phone:252-347-8743
Mailing Address - Fax:
Practice Address - Street 1:219 COMMERCE ST STE D
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5031
Practice Address - Country:US
Practice Address - Phone:252-758-8636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-04
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18707101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional