Basic Information
| Provider Information | |||||||||
| NPI: | 1851624993 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DIXIE | ||||||||
| FirstName: | CECELIA | ||||||||
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| Credential: | M.S.W. - LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3300 STADIUM DR | ||||||||
| Address2: | APT. 210 | ||||||||
| City: | PHENIX CITY | ||||||||
| State: | AL | ||||||||
| PostalCode: | 368673184 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7065664602 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1700 CLAIRMONT RD | ||||||||
| Address2: | |||||||||
| City: | DECATUR | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300334032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4043216111 | ||||||||
| FaxNumber: | 4049295819 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/08/2009 | ||||||||
| LastUpdateDate: | 04/04/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | CSW005169 | GA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.