Individual
CAROLYN R. DIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW, LCDCIII
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCDCIII.161663
OH
104100000X
Social Worker
Primary
S.1801990
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0265046
—
OH
Enumeration date
11/21/2017
Last updated
06/22/2018
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