=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659124980
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DORSETT COUNSELING SERVICES, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/08/2024
-----------------------------------------------------
Last Update Date | 04/08/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | DORSETT COUNSELING SERVICES, PLLC 5742 ADAMS AVE. PARKWAY
-----------------------------------------------------
City | WASHINGTON TERRACE
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84405
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-380-7322
-----------------------------------------------------
Fax | 801-452-6743
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4471 S 200 W
-----------------------------------------------------
City | WASHINGTON TERRACE
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84405-5709
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-380-7322
-----------------------------------------------------
Fax | 801-452-6743
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/THERAPIST
-----------------------------------------------------
Name | BRET O DORSETT
-----------------------------------------------------
Credential | LCMHC, LPC
-----------------------------------------------------
Telephone | 801-380-7322
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0850X
-----------------------------------------------------
Taxonomy Name | Adult Mental Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------