Healthcare Provider Details

I. General information

NPI: 1104425578
Provider Name (Legal Business Name): AMANDA DORSEY LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2020
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 262
DICKINSON ND
58602-0262
US

IV. Provider business mailing address

10220 JOE EBERT RD
SEFFNER FL
33584-2639
US

V. Phone/Fax

Practice location:
  • Phone: 760-500-5262
  • Fax:
Mailing address:
  • Phone: 760-500-5262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberTPMF1734
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number113936
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: