Individual provider Active NPI

Chiquita Deborah Dixon, LCSW

  • Clinical Social Worker
  • Chicago Heights, IL
National Provider Identifier
1588222012
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.020869 Issued in IL
Practice address
500 Dixie Hwy
Chicago Heights, IL 60411-1741
Phone
(708) 625-4796
NPI assigned
May 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X IL
Clinical Social Worker 1041C0700X 149.020869 IL Primary

Addresses

Primary practice location

500 Dixie Hwy
Chicago Heights, IL 60411-1741

Mailing address

9143 S Urban Ave
Chicago, IL 60619-6645

Other practice location 1

1536 Vincennes Ave
Chicago Heights, IL 60411-3458
Phone (312) 550-3116

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
149.020869ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Aunt Martha'S Health and Wellness, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: chiquita.dixon.1@13826.direct.athenahealth.com

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1588222012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9143 S URBAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606196645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 DIXIE HWY",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604111741",
            "telephone_number": "708-625-4796"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1536 Vincennes Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago Heights",
            "state": "IL",
            "postal_code": "604113458",
            "country_code": "US",
            "telephone_number": "312-550-3116",
            "fax_number": "708-754-2051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIXON",
        "first_name": "CHIQUITA",
        "middle_name": "DEBORAH",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-30",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.020869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.