Jackson, Dixie L

Jackson, Dixie L is an individual health care provider with primary practice located at 800 E Blackhawk Ave , Prairie Du Chien WI 53821-1698. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Jackson, Dixie L can be contacted via phone (608) 326-0808.

Contact Information

Primary practice address
800 E Blackhawk Ave Prairie Du Chien WI 53821-1698
Phone: (608) 326-0808
Fax: (608) 326-0810
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X 3842 Wisconsin
Behavioral Health & Social Service Providers / Professional 101YP2500X 3842 Wisconsin

Profile Details

NPI number 1396917266
LBN Legal business name Jackson, Dixie L
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2008
Last updated Mar 31st, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396917266 NPPES
Wisconsin MEDICAID 43713500

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