Provider Demographics
NPI:1275119307
Name:DOCKSIDE THERAPY PLLC
Entity Type:Organization
Organization Name:DOCKSIDE THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CEO PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:586-917-6612
Mailing Address - Street 1:46800 JANS DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047-5126
Mailing Address - Country:US
Mailing Address - Phone:586-917-6612
Mailing Address - Fax:313-509-3967
Practice Address - Street 1:46800 JANS DR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-5126
Practice Address - Country:US
Practice Address - Phone:586-917-6612
Practice Address - Fax:313-509-3967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-19
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty