Healthcare Provider Details

I. General information

NPI: 1982732004
Provider Name (Legal Business Name): KATHY L DORCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHY L WEST ED.D, LMHC, LPC,

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 02/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17901 CAUFIELD RD
SPRING HILL FL
34610-3013
US

IV. Provider business mailing address

RR 3 BOX 9177
DONIPHAN MO
63935-8758
US

V. Phone/Fax

Practice location:
  • Phone: 850-712-6699
  • Fax:
Mailing address:
  • Phone: 850-712-6699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH 11059
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2012029826
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: