Provider Demographics
NPI:1710251301
Name:DIXON HATHCOCK, KAREN (LMHC)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:DIXON HATHCOCK
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:MARIE
Other - Last Name:DIXON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:178 WORTHINGTON PKWY
Mailing Address - Street 2:
Mailing Address - City:ST JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-6916
Mailing Address - Country:US
Mailing Address - Phone:904-314-3380
Mailing Address - Fax:
Practice Address - Street 1:178 WORTHINGTON PKWY
Practice Address - Street 2:
Practice Address - City:ST JOHNS
Practice Address - State:FL
Practice Address - Zip Code:32259-6916
Practice Address - Country:US
Practice Address - Phone:904-789-7199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7786101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health