Individual
CHARLIE DIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCAC
Contact information
Practice address
710 E 12TH ST, NEWTON, KS 67114-2356
(316) 283-7829
(316) 283-7449
Mailing address
130 E 5TH ST, BOX 711, NEWTON, KS 67114-2206
(316) 283-6743
(316) 283-6830
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
180
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100106710 B
—
KS
05
—
100106710 C
—
KS
Enumeration date
06/11/2014
Last updated
06/11/2014
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