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General NPI Number Information
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NPI Number | 1366336117
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Entity Type | Organization
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Legal Business Name | STEPHANIE DORSEY LICENSED CLINICAL SOCIAL WORKER PC
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Dates
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Enumeration Date | 06/05/2025
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 111 MAIN ST UNIT 37
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City | SAN ANDREAS
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State | CA
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Zip | 95249-9332
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Country | US
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Telephone | 209-297-1911
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1113
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City | SAN ANDREAS
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State | CA
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Zip | 95249-1113
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Country | US
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Telephone | 209-297-1911
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. STEPHANIE DORSEY
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Credential | LCSW
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Telephone | 209-297-1911
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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 |
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License Number State |
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