Provider Demographics
NPI:1861363848
Name:DIXON, KERRI NICOLE (LPCC)
Entity type:Individual
Prefix:MS
First Name:KERRI
Middle Name:NICOLE
Last Name:DIXON
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 PEACAN DR
Mailing Address - Street 2:
Mailing Address - City:CORNETTSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41731-8540
Mailing Address - Country:US
Mailing Address - Phone:606-216-4615
Mailing Address - Fax:
Practice Address - Street 1:715 PEACAN DR
Practice Address - Street 2:
Practice Address - City:CORNETTSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41731-8540
Practice Address - Country:US
Practice Address - Phone:606-216-4615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY301623101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor