Healthcare Provider Details

I. General information

NPI: 1457281065
Provider Name (Legal Business Name): MALACHI DIXON MSW, LCSWA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 S LASALLE ST
DURHAM NC
27705-3701
US

IV. Provider business mailing address

411 S LASALLE ST
DURHAM NC
27705-3701
US

V. Phone/Fax

Practice location:
  • Phone: 704-493-7695
  • Fax: 919-383-8580
Mailing address:
  • Phone: 704-493-7695
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: