Provider Demographics
NPI:1851781363
Name:DIX, HEATHER (LPC, LMHC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:DIX
Suffix:
Gender:F
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 SILVER SADDLE RD
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-8006
Mailing Address - Country:US
Mailing Address - Phone:515-491-1484
Mailing Address - Fax:
Practice Address - Street 1:660 SILVER SADDLE RD
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-8006
Practice Address - Country:US
Practice Address - Phone:719-357-9411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-04
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0006224101YP2500X
IA074893101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional