Organization
DIXON SOCIAL INTERACTIVE SERVICES, INC.
Active
Organization
DIXON SOCIAL INTERACTIVE SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DERRIA DIXON (CFO)
(252) 258-8946
Entity
Organization
Contact information
Practice address
313 CLIFTON ST., GREENVILLE, NC 27858-8504
(252) 353-0100
(252) 364-8117
Mailing address
PO BOX 30166, GREENVILLE, NC 27833-0166
(252) 353-0100
(252) 364-8117
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
200100499
NC
101YM0800X
Mental Health Counselor
200100499
NC
101YP2500X
Professional Counselor
Primary
200100499
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6005438
—
NC
Enumeration date
05/02/2007
Last updated
12/15/2011
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