Provider Demographics
NPI:1881895811
Name:WHITE DIXON, LYNNE PAULETTE (LCSW)
Entity type:Individual
Prefix:MS
First Name:LYNNE
Middle Name:PAULETTE
Last Name:WHITE DIXON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:563 FIGUEROA ST
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-3232
Mailing Address - Country:US
Mailing Address - Phone:831-375-7572
Mailing Address - Fax:831-646-9581
Practice Address - Street 1:563 FIGUEROA ST
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-3232
Practice Address - Country:US
Practice Address - Phone:831-375-7572
Practice Address - Fax:831-646-9581
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS69621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical