Provider Demographics
NPI:1770959595
Name:DIXON-TALIAFERRO, CARA (LMHC)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:DIXON-TALIAFERRO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:CARA
Other - Middle Name:
Other - Last Name:DIXON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8884 FOUNDERS CIR
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-1308
Mailing Address - Country:US
Mailing Address - Phone:941-465-0686
Mailing Address - Fax:727-623-4283
Practice Address - Street 1:200 CENTRAL AVE
Practice Address - Street 2:SUITE 18-G
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4353
Practice Address - Country:US
Practice Address - Phone:941-465-0686
Practice Address - Fax:727-623-4283
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-16
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 13626101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health