MEDICARE: MS. ASHLEY NICOLE DIXON LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	CW026567	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CW026567	OTHER	PA	ASWB

General Provider Information

NPI Number	:	1427754035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ASHLEY NICOLE DIXON LCSW

Provider Business Mailing Address
First Line	:	307 N HILLS AVE
Second Line	:
City	:	GLENSIDE
State	:	PA
Zip	:	19038-1625
Country	:	US
Telephone Number	:	215-696-3628
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 S 15TH ST STE 747765
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19102-4826
Country	:	US
Telephone Number	:	215-867-9314
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2023
Last Update Date	:	10/15/2025

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