MEDICARE: JULIE LYN DIXON L.C.P.C.

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	101YP2500X	Professional Counselor	LC0989	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437181096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE LYN DIXON L.C.P.C.

Provider Business Mailing Address
First Line	:	200 WYE RD
Second Line	:
City	:	QUEENSTOWN
State	:	MD
Zip	:	21658-1189
Country	:	US
Telephone Number	:	410-827-5485
Fax Number	:

Provider Business Practice Location Address
First Line	:	721 MAIN ST
Second Line	:	SUITE 100
City	:	STEVENSVILLE
State	:	MD
Zip	:	21666-4068
Country	:	US
Telephone Number	:	410-490-6852
Fax Number	:	410-604-3704

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

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	12/16/2014

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