Provider Demographics
NPI:1780965251
Name:DIXON, TAMITHA R
Entity type:Individual
Prefix:MRS
First Name:TAMITHA
Middle Name:R
Last Name:DIXON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:TAMITHA
Other - Middle Name:R
Other - Last Name:DODSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:64 PLAYA DEL COCO CT STE 158
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-8105
Mailing Address - Country:US
Mailing Address - Phone:702-544-3672
Mailing Address - Fax:
Practice Address - Street 1:526 S TONOPAH DR STE 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4013
Practice Address - Country:US
Practice Address - Phone:725-257-9639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-29
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner