Healthcare Provider Details

I. General information

NPI: 1144168675
Provider Name (Legal Business Name): KINDEE DIXON LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1078 W PARK PALISADE DR
SOUTH JORDAN UT
84095-2229
US

IV. Provider business mailing address

1078 W PARK PALISADE DR
SOUTH JORDAN UT
84095-2229
US

V. Phone/Fax

Practice location:
  • Phone: 801-755-7007
  • Fax:
Mailing address:
  • Phone: 801-755-7007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number288554-6004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: