Healthcare Provider Details

I. General information

NPI: 1255680385
Provider Name (Legal Business Name): SARAH DORRIS MA, LPC, CAADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2012
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20303 KELLY RD
HARPER WOODS MI
48225-1206
US

IV. Provider business mailing address

9844 DIXIE HWY
IRA MI
48023-2813
US

V. Phone/Fax

Practice location:
  • Phone: 313-245-7000
  • Fax: 313-245-7009
Mailing address:
  • Phone: 586-716-7600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401013021
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: