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General NPI Number Information
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NPI Number | 1629351648
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Entity Type | Organization
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Legal Business Name | DORRIS COUNSELING & CONSULTING, LLC
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Dates
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Enumeration Date | 09/26/2011
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Last Update Date | 09/26/2011
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Provider Practice Location Address
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Address Line | 906 N COURT ST SUITE C
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City | CIRCLEVILLE
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State | OH
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Zip | 43113-1230
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Country | US
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Telephone | 740-497-4881
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Fax | 740-497-4882
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Provider Business Mailing Address
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Address Line | PO BOX 1088
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City | CIRCLEVILLE
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State | OH
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Zip | 43113-5088
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Country | US
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Telephone | 740-497-4881
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Fax | 740-497-4882
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Authorized Official
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Title or Position | OWNER/SOLE PROPRIETOR
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Name | MS. CARMEN YOLANDA DORRIS
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Credential | LPCC-S, LICDC
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Telephone | 740-497-4881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 82786
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E1253
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License Number State | OH
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