Provider Demographics
NPI:1083425409
Name:MK DIXON COUNSELING AND CONSULTING
Entity type:Organization
Organization Name:MK DIXON COUNSELING AND CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KIZZY
Authorized Official - Middle Name:
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:337-534-0254
Mailing Address - Street 1:75 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:LA
Mailing Address - Zip Code:70538-7026
Mailing Address - Country:US
Mailing Address - Phone:337-534-0254
Mailing Address - Fax:337-534-0542
Practice Address - Street 1:300 RUE BEAUREGARD STE F
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-8511
Practice Address - Country:US
Practice Address - Phone:337-534-0254
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MK DIXON COUNSELING AND CONSULTING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty