NPIMap

Larry E Dixon, L.S.A.C.

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Delta, UT

NPI 1124266903 · NPPES record last updated Feb 1, 2009

Key facts

NPI
1124266903
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
331882-6006 (UT)
Practice address
58 E Main St Ste 7
Delta, UT 84624-9500
Phone
(435) 979-6372
Fax
(435) 864-1669
NPI assigned
Feb 1, 2009
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
331882-6006UTMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
New Beginnings at Seven D'S Ranch Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 331882-6006 UT Yes

Addresses

Primary practice location

58 E Main St Ste 7
Delta, UT 84624-9500

Mailing address

PO Box 387
Delta, UT 84624-0387
Phone (435) 979-6372

Other providers in Delta, UT

All providers in Delta, UT · Addiction (Substance Use Disorder) Counselor in Utah

Sources for this page

Verify at the official NPI Registry.