Antwan Tavarious Dixon LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

ANTWAN TAVARIOUS DIXON LLC

Practice address

2100 Southbridge Pkwy Ste 650
Birmingham, AL 35209-1317

Phone

(800) 916-3713

NPI assigned

Nov 28, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Antwan Tavarious Dixon, EDS, LPC, NCCNPI 1295203610

Title

Owner/Licensed Prof. Counselor

Phone

(800) 916-3713

Specialties & licenses 1

Addresses

Other names 1

• Accomplishing Goals Counseling Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Antwan Tavarious Dixon, LPC

  • Professional Counselor
  • Kennesaw, GA
  • NPI 1295203610
  NPD Authorized official

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

{
    "created_epoch": "1669593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669593600000",
    "number": "1760192280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 SOUTHBRIDGE PKWY STE 650",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352091317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 SOUTHBRIDGE PKWY STE 650",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352091317",
            "telephone_number": "800-916-3713"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1144 Ware Blvd",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352351535",
            "country_code": "US",
            "telephone_number": "800-916-3713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ANTWAN TAVARIOUS DIXON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-28",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-26",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "ANTWAN",
        "authorized_official_middle_name": "TAVARIOUS",
        "authorized_official_title_or_position": "OWNER/LICENSED PROF. COUNSELOR",
        "authorized_official_telephone_number": "800-916-3713",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "EDS, LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Accomplishing Goals Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Professional Counselor in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Professional Counselor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; 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.