Provider Demographics
NPI:1326559618
Name:DIXON, ANNA CHRISTINE (LPC, LCPC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:CHRISTINE
Last Name:DIXON
Suffix:
Gender:F
Credentials:LPC, LCPC
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:RAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:1800 COMMUNITY
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MO
Mailing Address - Zip Code:64735-8804
Mailing Address - Country:US
Mailing Address - Phone:660-885-8131
Mailing Address - Fax:
Practice Address - Street 1:93 N KAINALU DR STE B
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2331
Practice Address - Country:US
Practice Address - Phone:808-909-8095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-13
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT25782101YM0800X
MTBBH-LCPC-LIC-25782101YP2500X
MO2019031590101YP2500X
HIMHC-1082101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0MT0744431OtherBLUE CROSS-SHIELD OF MONTANA