Provider Demographics
NPI:1558829994
Name:DIXON, ESTHER FREDRICA (LCAS)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:FREDRICA
Last Name:DIXON
Suffix:
Gender:F
Credentials:LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3755 ADMIRAL DR STE 105A
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-1554
Mailing Address - Country:US
Mailing Address - Phone:336-210-8409
Mailing Address - Fax:336-203-3644
Practice Address - Street 1:3755 ADMIRAL DR STE 105A
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-1554
Practice Address - Country:US
Practice Address - Phone:336-673-5097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-05
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-24421101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)