Provider Demographics
NPI:1174581136
Name:DORMAN, LINDA (MSW, LMSW, LCAS)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:DORMAN
Suffix:
Gender:F
Credentials:MSW, LMSW, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 BIRCH CREEK DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-4271
Mailing Address - Country:US
Mailing Address - Phone:810-772-3329
Mailing Address - Fax:
Practice Address - Street 1:1008 BIRCH CREEK DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-4271
Practice Address - Country:US
Practice Address - Phone:810-772-3329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010860901041C0700X
MIC-01428101YA0400X
NC3108101YA0400X
NCC0083671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)