Provider Demographics
NPI:1053687228
Name:DORSEY, KATHERINE MCMANUS (LPC, ATR, CACI)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MCMANUS
Last Name:DORSEY
Suffix:
Gender:F
Credentials:LPC, ATR, CACI
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:DORSEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:791 RUTLEDGE AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-3741
Mailing Address - Country:US
Mailing Address - Phone:404-394-8058
Mailing Address - Fax:
Practice Address - Street 1:3030 ASHLEY TOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5664
Practice Address - Country:US
Practice Address - Phone:404-394-8058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-31
Last Update Date:2012-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5333101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional