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General NPI Number Information
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NPI Number | 1174581136
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Entity Type | Individual
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Provider Name | LINDA DORMAN MSW, LMSW, LCAS
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Gender | Female
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Dates
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Enumeration Date | 05/01/2006
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Last Update Date | 09/10/2013
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Provider Practice Location Address
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Address Line | 1008 BIRCH CREEK DR
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City | WILMINGTON
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State | NC
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Zip | 28403-4271
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Country | US
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Telephone | 810-772-3329
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Fax |
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Provider Business Mailing Address
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Address Line | 1008 BIRCH CREEK DR
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City | WILMINGTON
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State | NC
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Zip | 28403-4271
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Country | US
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Telephone | 810-772-3329
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801086090
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | C-01428
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 3108
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C008367
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License Number State | NC
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