Provider Demographics
NPI:1578002168
Name:DORPFELD, SALLY JOHANNA (LMHC,LPC,MCAP,ICADC)
Entity Type:Individual
Prefix:MRS
First Name:SALLY
Middle Name:JOHANNA
Last Name:DORPFELD
Suffix:
Gender:F
Credentials:LMHC,LPC,MCAP,ICADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7604 SIERRA RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-7917
Mailing Address - Country:US
Mailing Address - Phone:561-758-4464
Mailing Address - Fax:
Practice Address - Street 1:600 S EAST COAST AVE
Practice Address - Street 2:
Practice Address - City:LANTANA
Practice Address - State:FL
Practice Address - Zip Code:33462-4577
Practice Address - Country:US
Practice Address - Phone:561-578-5700
Practice Address - Fax:561-337-3400
Is Sole Proprietor?:No
Enumeration Date:2017-02-16
Last Update Date:2021-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH 15365101YM0800X
FLMH16944101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH16944OtherTHE FLORIDA BOARD OF CLINICAL SOCIAL WORK, MARRIAGE&FAM. THERAPY MH COUNSELING