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NPI Code Detail

MEDICARE: MRS. JAMIE EDWARDS DIXON LICSW, LCSW-C

MEDICARE: MRS. JAMIE EDWARDS DIXON LICSW, LCSW-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
11041C0700XClinical Social Worker14602MD
21041C0700XClinical Social WorkerLC303476DC

General Provider Information

NPI Number : 1952405532
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JAMIE EDWARDS DIXON LICSW, LCSW-C
Provider Business Mailing Address
First Line : 13110 FALLING WATER CT
Second Line :
City : BOWIE
State : MD
Zip : 20720-3270
Country : US
Telephone Number : 202-491-3298
Fax Number :
Provider Business Practice Location Address
First Line : 915 RHODE ISLAND AVE NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20001-4153
Country : US
Telephone Number : 202-403-2801
Fax Number : 202-483-4560
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2006
Last Update Date : 04/18/2014

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