Provider Demographics
NPI:1407221393
Name:DORRILL, BRADLEY (LMHC)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:
Last Name:DORRILL
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 STICKNEY POINT RD STE 210
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-6000
Mailing Address - Country:US
Mailing Address - Phone:941-376-6758
Mailing Address - Fax:941-218-2447
Practice Address - Street 1:2750 STICKNEY POINT RD STE 210
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-6000
Practice Address - Country:US
Practice Address - Phone:941-376-6758
Practice Address - Fax:941-218-2447
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-03
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH13509101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health