ODELL LEVI DIXON (NPI# 1548861842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548861842 |
| Entity Type | Individual |
| Full Name | ODELL LEVI DIXON |
| Credential | PSS |
| Practice Address |
105 S Main Cross St Louisa KY 40517 |
| Practice Telephone | 6066390938 |
| Practice Fax Number | 8598135394 |
| Mailing Telephone | 6066390938 |
| Mailing Fax Number | 8598135394 |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2020-11-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
105 S MAIN CROSS ST |
| City | LOUISA |
| State | KY |
| Zip Code | 40517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538638515 | Lionheart Trauma Support Services, LLC | Social Worker | 168 E Reynolds Rd., Suite 210, Lexington, KY 40517 | 2018-11-19 |
| 1467964486 | Leila M Goodpaster | Counselor | 3205 Elk Lake Ct., Lexington, KY 40517 | 2017-10-31 |
| 1588108609 | Body Structure Clinic | Dietitian, Registered | 2600 Gribbin Dr., Lexington, KY 40517 | 2016-12-08 |
| 1932538766 | Lydia Akin | Social Worker | 3150 Custer Dr., Suite 103, Lexington, KY 40517 | 2013-11-02 |
| 1083986335 | Family Counseling Service | Social Worker | 1393 Trent Blvd., Lexington, KY 40517 | 2012-02-02 |
| 1356624233 | Michael Glindmeyer | Physical Therapist | 2600 Gribbin Drive, Lexington, KY 40517 | 2011-09-27 |
| 1740574052 | Benjamin Marshall | Psychiatry & Neurology | 228 E. Reynolds Rd, Ste B2, Lexington, KY 40517 | 2011-06-03 |
| 1982913745 | Cynae Rashel Carter | Social Worker | 343 Waller Avenue, Suite 201, Lexington, KY 40517 | 2010-09-28 |
| 1548401185 | Jason Eugene Thomas | Counselor | 1393 Trent Boulevard, Building 2, Suite 2101, Lexington, KY 40517 | 2009-03-11 |
| 1609046796 | Elizabeth Lagesse O'nan | Physical Therapist | 2600 Gribbon Drive, Lexington, KS 40517 | 2008-03-05 |
| Find all providers in zip 40517 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922528272 | Samantha Paige Stanley | Peer Specialist | 221 Windy Hill Drive, Louisa, KY 41230 | 2017-06-27 |
| 1407393457 | Chandra D Blevins | Peer Specialist | 125 N. Main Cross St., Louisa Office Addiction Recovery Care, Louisa, KY 41230 | 2017-01-30 |
| 1033654876 | Amanda Hurley | Peer Specialist | 125 N. Main Cross Street, Louisa, KY 41230 | 2017-01-04 |
| 1780127753 | Dakota Williams | Peer Specialist | 125 N Cross Main St, Louisa, KY 41230 | 2016-11-23 |
| 1568905529 | Tara Runyon | Peer Specialist | 125 N Main Cross Street, Louisa, KY 41230 | 2016-11-23 |
| 1518313014 | Latasha Leighann Byrd | Peer Specialist | 3651 Us Highway 2565, Louisa, KY 41320 | 2016-05-13 |
| 1134575624 | Misty Howell I | Peer Specialist | 125 S. Main Cross Street, Louisa, KY 41230 | 2016-05-13 |
| 1942655766 | Ashlea Leslie | Peer Specialist | 3651 Highway 2565, Louisa, KY 41230-5018 | 2016-04-29 |
| 1225483019 | Sara Young I | Peer Specialist | 2135 Highway 1185, Louisa, KY 41230-7968 | 2016-04-28 |
| 1124629282 | Brittany Baker | Peer Specialist | 125 S Main Cross St, Louisa, KY 41230-1065 | 2020-11-05 |
| Find all providers in LOUISA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.