Emily Goff Dixon, LCSW

Individual provider Active NPI Social Worker · Hattiesburg, MS

NPI 1609429083 · NPPES record last updated Feb 21, 2022

Key facts

NPI
1609429083
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
License
M8889 (MS)
Practice address
415 S 28TH Ave FL 1
Hattiesburg, MS 39401-7246
Phone
(601) 579-3300
NPI assigned
Jul 24, 2019
Sex
Female
Sole proprietor
No

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 Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1128 Wayne Lee Rd
Lucedale, MS 39452-7233

PO Box
Suite 923
Hurley, MS 39555

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MS
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
I20260323002666 MS Practitioner - Clinical Social Worker 0749764223 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
M8889MSMDSocial Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X M8889 MS Yes

Addresses

Primary practice location

415 S 28TH Ave FL 1
Hattiesburg, MS 39401-7246

Mailing address

415 S 28TH Ave FL 1
Hattiesburg, MS 39401-7246
Phone (601) 579-3300

Other providers in Hattiesburg, MS

All providers in Hattiesburg, MS · Social Worker in Mississippi

Sources for this page

Verify at the official NPI Registry.