Healthcare Provider Details

I. General information

NPI: 1346157674
Provider Name (Legal Business Name): BRANDON DOTY LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9992 RACINE ST
COMMERCE CITY CO
80022-5039
US

IV. Provider business mailing address

9992 RACINE ST
COMMERCE CITY CO
80022-5039
US

V. Phone/Fax

Practice location:
  • Phone: 224-639-5955
  • Fax:
Mailing address:
  • Phone: 224-639-5955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC.0023670
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: