Provider Demographics
NPI:1871650077
Name:MYERS, DIXIE M (LPC)
Entity type:Individual
Prefix:
First Name:DIXIE
Middle Name:M
Last Name:MYERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:DIXIE
Other - Middle Name:M
Other - Last Name:PRITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:2000 EOFF ST
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-3823
Mailing Address - Country:US
Mailing Address - Phone:304-234-8663
Mailing Address - Fax:304-234-8960
Practice Address - Street 1:2101 JACOB ST STE 501
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-3800
Practice Address - Country:US
Practice Address - Phone:304-234-8517
Practice Address - Fax:304-234-8745
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1964101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001712839OtherMOUNTAIN STATE ID NUMBER
WV0005456001Medicaid