Jackie Denise Dixon, LCSW

Individual provider Active NPI Clinical Social Worker · Bainbridge, GA

NPI 1447528526 · NPPES record last updated Sep 30, 2025

Key facts

NPI
1447528526
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
CSW006353 (GA)
Practice address
904 N Miller Ave
Bainbridge, GA 39817-2640
Phone
(229) 416-6155
NPI assigned
Dec 5, 2011
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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 Care Compare profile

Specialty
Clinical Social Worker
Education
Florida State University College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sondermind Provider Network LLC (1,295 clinicians)

Practice addresses (Care Compare)

3372 Peachtree Rd NE
Suite 115
Atlanta, GA 30326-1963
Phone (866) 630-0966

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240314002928 GA Practitioner - Clinical Social Worker 1557707304 Reassigns benefits to 1 organization
Practice locations: Bainbridge, GA

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Bridge of Hope Counseling Services, LLC Current
since May 12, 2024
Accepting new patients
Sondermind Provider Network LLC Clinical Current
since Sep 10, 2024
Accepting new patients

Locations

3348 Peachtree Rd NE
Ste 700
Atlanta, GA 30326
Phone (720) 712-7900

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW006353 GA Yes

Addresses

Primary practice location

904 N Miller Ave
Bainbridge, GA 39817-2640

Mailing address

904 N Miller Ave
Bainbridge, GA 39817-2640
Phone (229) 416-6155

Other names

  • Jackie Denise Dixon Professional name

Other providers in Bainbridge, GA

All providers in Bainbridge, GA · Clinical Social Worker in Georgia

Sources for this page

Verify at the official NPI Registry.