Individual provider Active NPI

Stephanie Elizabeth Dixon, LPC

  • Professional Counselor
  • Savannah, GA
National Provider Identifier
1720383045
Registry record updated May 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC005343 Issued in GA
Practice address
24 Ranchland Dr
Savannah, GA 31404-5802
Phone
(912) 660-9443
Fax
(912) 354-1440
NPI assigned
Jan 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC005343 GA Primary

Addresses

Primary practice location

24 Ranchland Dr
Savannah, GA 31404-5802

Mailing address

24 Ranchland Dr
Savannah, GA 31404-5802
Phone (912) 660-9443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240705000192 GA Practitioner - Mental Health Counselor 6406399104 Reassigns benefits to 2 organizations
I20250115002021 SC Practitioner - Mental Health Counselor 6406399104 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPCSCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Professional CurrentSince Nov 18, 2024 Accepting new patients

Locations

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

110 Traders Cross
Okatie, SC 29909
Phone (602) 675-0335

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.

NPI Registry JSON

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

{
    "created_epoch": "1295308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369785600000",
    "number": "1720383045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 RANCHLAND DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314045802",
            "telephone_number": "912-660-9443",
            "fax_number": "912-354-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 RANCHLAND DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314045802",
            "telephone_number": "912-660-9443",
            "fax_number": "912-354-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "STEPHANIE",
        "middle_name": "ELIZABETH",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-18",
        "last_updated": "2013-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC005343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.