Provider Demographics
NPI:1811762719
Name:DIXON, JOHN CHRISTOPHER (LMHC)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:CHRISTOPHER
Last Name:DIXON
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:MR
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:DIXON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:5302 S FLORIDA AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-4910
Mailing Address - Country:US
Mailing Address - Phone:186-325-5478
Mailing Address - Fax:
Practice Address - Street 1:5302 S FLORIDA AVE STE 206
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-4910
Practice Address - Country:US
Practice Address - Phone:186-325-5478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH19020101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health