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NPI Code Detail

MEDICARE: TANISHA L. PERINE-DIXON LPCC

MEDICARE: TANISHA L. PERINE-DIXON LPCC
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
1101YP2500XProfessional CounselorC.1000454OH
2101YA0400XAddiction (Substance Use Disorder) Counselor110327OH
3101YP2500XProfessional CounselorE.2001829OH

General Provider Information

NPI Number : 1679854384
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANISHA L. PERINE-DIXON LPCC
Provider Business Mailing Address
First Line : 401 E MCMILLAN ST
Second Line :
City : CINCINNATI
State : OH
Zip : 45206-1922
Country : US
Telephone Number : 513-221-3350
Fax Number : 513-948-0087
Provider Business Practice Location Address
First Line : 401 E MCMILLAN ST
Second Line :
City : CINCINNATI
State : OH
Zip : 45206-1922
Country : US
Telephone Number : 513-221-3350
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2011
Last Update Date : 08/17/2020

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