Provider Demographics
NPI:1215621024
Name:DIXON, BENJAMIN LEE (MA)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:LEE
Last Name:DIXON
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1339 CHIPPENDALE CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-7206
Mailing Address - Country:US
Mailing Address - Phone:931-374-7672
Mailing Address - Fax:
Practice Address - Street 1:2525C LEBANON PIKE STE 202
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-2418
Practice Address - Country:US
Practice Address - Phone:615-854-8231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional