Provider Demographics
NPI:1295178705
Name:PIERRE DORMEUS, CLICILE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CLICILE
Middle Name:
Last Name:PIERRE DORMEUS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2170 NW 85TH AVE
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33322-3816
Mailing Address - Country:US
Mailing Address - Phone:954-892-4723
Mailing Address - Fax:
Practice Address - Street 1:3810 INVERRARY BLVD STE 404A
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-4381
Practice Address - Country:US
Practice Address - Phone:954-892-4723
Practice Address - Fax:954-507-7408
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-15
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW113101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical