Provider Demographics
NPI:1528551314
Name:DORTON THERAPY SERVICES
Entity Type:Organization
Organization Name:DORTON THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:DORTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:415-200-8957
Mailing Address - Street 1:3000 FARNAM ST STE 6
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-3521
Mailing Address - Country:US
Mailing Address - Phone:415-200-8957
Mailing Address - Fax:515-724-7468
Practice Address - Street 1:3000 FARNAM ST STE 6
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-3521
Practice Address - Country:US
Practice Address - Phone:415-200-8957
Practice Address - Fax:515-724-7468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-07
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4983101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty