Provider Demographics
NPI:1053459248
Name:DORSEY, MICHAEL (LMHC CDP)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:DORSEY
Suffix:
Gender:M
Credentials:LMHC CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10726 MANITOU BEACH DR NE
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-3370
Mailing Address - Country:US
Mailing Address - Phone:206-349-7032
Mailing Address - Fax:
Practice Address - Street 1:18777 9TH AVE NE
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-8402
Practice Address - Country:US
Practice Address - Phone:360-697-1079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00004029101YA0400X
WALH00009049101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health