MEDICARE: KATHY L DORCH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker
2	101YM0800X	Mental Health Counselor	MH 11059	FL
3	101YP2500X	Professional Counselor	2012029826	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982732004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHY L DORCH

Provider Business Mailing Address
First Line	:	RR 3 BOX 9177
Second Line	:
City	:	DONIPHAN
State	:	MO
Zip	:	63935-8758
Country	:	US
Telephone Number	:	850-712-6699
Fax Number	:

Provider Business Practice Location Address
First Line	:	17901 CAUFIELD RD
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34610-3013
Country	:	US
Telephone Number	:	850-712-6699
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	02/12/2016

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